Brochard L, Piquet J, Baldeyrou P, Lecocguic Y, Murciano D, Grenier P, Pariente R
Rev Mal Respir. 1986;3(4):187-94.
26 patients presenting with panlobular emphysema between 1978 and 1984 were submitted to a thoracotomy for surgical resection of their bullae. Pre-operative and post-operative evaluations of the following were made: The level of dyspnoea in 5 grades. The FEV1 (VEMS) the forced vital capacity (CVF) the functional residual capacity (CRF) measured plethysmographically, the residual volume (VR), the total lung capacity (CPT). Arterial blood gases. The presence of radiological signs of compression on pulmonary angiography and on plain chest radiographs: an index of compression rated 0 to 6 was defined at the outset. The subjects were split into 3 groups based on their post-operative respiratory function: Group 1: no improvement (n = 7). Group 2: moderate improvement of dyspnoea (n = 11). Group 3: a big improvement in dyspnoea (n = 7). These three groups were homogenous as regards their preoperative respiratory function. On the other hand, the compression caused by the bullae based on the pre-operative radiological data was much greater (p 0.01) in the group of patients who improved. In addition when the index of compression was equal or superior to 3 (n = 14) all the patients were improved (n = 6). The comparison of pre- and post-operative values shows the following results: The change in blood gases was very limited in all groups; the ventilatory parameters were unchanged in group 1; on the other hand in group 2 and 3 one notes an overall improvement in pulmonary function. The size of the improvement however, was very variable from one individual to another.(ABSTRACT TRUNCATED AT 250 WORDS)
1978年至1984年间,26例患有全小叶型肺气肿的患者接受了开胸手术以切除肺大疱。对以下各项进行了术前和术后评估:5级呼吸困难程度;通过体积描记法测量的第一秒用力呼气容积(FEV1,即VEMS)、用力肺活量(FVC,即CVF)、功能残气量(FRC,即CRF)、残气量(RV)、肺总量(TLC,即CPT);动脉血气分析;肺血管造影和胸部X线平片上的压迫放射学征象:一开始定义了0至6级的压迫指数。根据术后呼吸功能将受试者分为3组:第1组:无改善(n = 7);第2组:呼吸困难中度改善(n = 11);第3组:呼吸困难大幅改善(n = 7)。这三组在术前呼吸功能方面具有同质性。另一方面,根据术前放射学数据,肺大疱引起的压迫在改善的患者组中要大得多(p < 0.01)。此外,当压迫指数等于或高于3时(n = 14),所有患者均有改善(n = 6)。术前和术后值的比较显示以下结果:所有组的血气变化非常有限;第1组的通气参数未改变;另一方面,第2组和第3组的肺功能总体有所改善。然而,改善的程度在个体之间差异很大。(摘要截断于250字)