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腹腔镜肺叶切除术前、后区域性通气分布。

Regional ventilation distribution before and after laparoscopic lung parenchymal resection.

机构信息

Department of Anesthesiology, the 986th Air Force Hospital, Xijing hospital, the Air Force Medical University, Xi'an, Shaanxi 710032, People's Republic of China.

Department of Aerospace Medicine, Air Force Medical University, Xi'an, People's Republic of China.

出版信息

Physiol Meas. 2024 Jan 31;45(1). doi: 10.1088/1361-6579/ad1b3b.

DOI:10.1088/1361-6579/ad1b3b
PMID:38176102
Abstract

The aim of the present study was to evaluate the influence of one-sided pulmonary nodule and tumour on ventilation distribution pre- and post- partial lung resection.A total of 40 consecutive patients scheduled for laparoscopic lung parenchymal resection were included. Ventilation distribution was measured with electrical impedance tomography (EIT) in supine and surgery lateral positions 72 h before surgery (T1) and 48 h after extubation (T2). Left lung to global ventilation ratio (), the global inhomogeneity index (GI), standard deviation of regional ventilation delay (RVD) and pendelluft amplitude () were calculated to assess the spatial and temporal ventilation distribution.After surgery (T2), ventilation at the operated chest sides generally deteriorated compared to T1 as expected. For right-side resection, the differences were significant at both supine and left lateral positions (< 0.001). The change of RVDwas in general more heterogeneous. For left-side resection, RVDwas worse at T2 compared to T1 at left lateral position (= 0.002). The other EIT-based parameters showed no significant differences between the two time points. No significant differences were observed between supine and lateral positions for the same time points respectively.In the present study, we found that the surgery side influenced the ventilation distribution. When the resection was performed on the right lung, the postoperative ipsilateral ventilation was reduced and the right lung ratio fell significantly. When the resection was on the left lung, the ventilation delay was significantly increased.

摘要

本研究旨在评估单侧肺结节和肿瘤对肺部分切除术前和术后通气分布的影响。

共纳入 40 例计划行腹腔镜肺实质切除术的连续患者。在术前 72 小时(T1)和拔管后 48 小时(T2),使用电阻抗断层成像(EIT)测量仰卧位和手术侧位时的通气分布。计算左肺与全肺通气比()、整体不均匀指数(GI)、区域通气延迟标准差(RVD)和 Pendelluft 幅度(),以评估通气的空间和时间分布。

手术后(T2),与 T1 相比,手术侧的通气通常恶化,这是预期的。对于右侧切除术,仰卧位和左侧卧位的差异均有统计学意义(<0.001)。RVD 的变化通常更不均匀。对于左侧切除术,与 T1 相比,T2 时左侧卧位的 RVD 更差(=0.002)。其他基于 EIT 的参数在两个时间点之间没有显著差异。对于同一时间点,仰卧位和侧卧位之间没有观察到显著差异。

在本研究中,我们发现手术侧会影响通气分布。当右肺切除时,术后同侧通气减少,右肺比明显下降。当左肺切除时,通气延迟明显增加。

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