Takkunen O, Mattila S, Nieminen M S, Sovijärvi A R, Luosto R, Merikallio E
Scand J Thorac Cardiovasc Surg. 1987;21(1):21-6. doi: 10.3109/14017438709116914.
Of 28 patients with total surgical correction of tetralogy of Fallot in adult life, 22 had previously undergone Blalock-Taussig shunt operation. Possible modifying effects of the shunt on pulmonary ventilation and perfusion and on exercise tolerance were investigated with spirometry, radiospirometry and bicycle ergometry. The observed ventilatory volumes and capacities and diffusing capacity were significantly lower than the predicted values. Vital capacity was significantly reduced in patients with adverse NYHA or haemodynamic classification. Between the various NYHA or haemodynamic groups no statistically significant difference was demonstrable in pulmonary function or diffusing capacity or in airway resistance. Ventilatory obstruction was found also in patients without previous shunt. Other lung function tests showed no significant difference between the shunt and the non-shunt group. Nor was distribution of lung perfusion significantly affected by shunt. No correlation was seen between lung function and bicycle ergometric findings. However, in non-shunt patients who had ventilatory obstruction or impaired diffusing capacity, exercise tolerance was significantly higher than in patients who had had palliative shunt.
在28例成年后接受法洛四联症完全手术矫正的患者中，22例此前接受过布莱洛克 - 陶西格分流术。通过肺活量测定法、放射性肺活量测定法和自行车测力计，研究了分流对肺通气、灌注及运动耐量的可能影响。观察到的通气量、容量和弥散能力显著低于预测值。纽约心脏协会（NYHA）分级或血流动力学分级不良的患者肺活量显著降低。在不同的NYHA分级或血流动力学组之间，肺功能、弥散能力或气道阻力无统计学显著差异。在未接受过分流术的患者中也发现了通气障碍。其他肺功能测试显示分流组和非分流组之间无显著差异。分流对肺灌注分布也无显著影响。肺功能与自行车测力计测试结果之间无相关性。然而，在存在通气障碍或弥散能力受损的非分流患者中，运动耐量显著高于接受过姑息性分流术的患者。
