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二尖瓣置换术对二尖瓣疾病患者肺通气、容量、弥散功能及肺局部灌注的影响。

Effects of mitral valve replacement on ventilation, volumes, diffusing capacity and regional perfusion of lungs in patients with mitral valve disease.

作者信息

Mattila S, Sovijärvi A R, Harjula A, Viljanen A, Takkunen O, Takkunen H, Mattila I, Mattila P, Merikallio E

出版信息

Ann Chir Gynaecol. 1985;74(2):82-5.

PMID:3875308
Abstract

The effects of mitral valve replacement on ventilation, lung volumes, diffusing capacity and regional perfusion of the lungs were studied in eight patients with long-standing mitral valve disease. Eight patients of the same age with coronary artery disease who underwent coronary bypass operation were tested as controls. Preoperatively, the patients with mitral valve disease had significantly higher perfusion of the upper lung fields and the ratio of residual volume to total lung capacity than the control patients. Vital capacity, forced expiratory volume in one second and maximal expiratory flow at 50% of vital capacity were lower in comparison with the control group. Seven days after open heart surgery the values of all the parameters mentioned above had decreased significantly from the preoperative levels in both groups. Three months post-operatively, the values returned to preoperative levels. The abnormal overperfusion of the upper lung fields and other derangements in the ventilatory pattern did not subside even though cardiac haemodynamics were corrected by mitral valve replacement.

摘要

对8例患有长期二尖瓣疾病的患者,研究了二尖瓣置换术对通气、肺容量、弥散能力和肺局部灌注的影响。选取8例年龄相同、接受冠状动脉搭桥手术的冠心病患者作为对照进行测试。术前,二尖瓣疾病患者上肺野的灌注以及残气量与肺总量的比值显著高于对照组患者。与对照组相比,其肺活量、一秒用力呼气量和肺活量50%时的最大呼气流量较低。心脏直视手术后7天,上述两组所有参数的值均较术前水平显著下降。术后3个月,这些值恢复到术前水平。尽管二尖瓣置换术纠正了心脏血流动力学,但上肺野异常的过度灌注和通气模式的其他紊乱并未消退。

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