Volovoĭ V L, Guliamov D S, Gafurov F Kh
Ter Arkh. 1985;57(4):122-5.
During rehabilitation of 40 patients after correction of mitral stenosis, a study was made of ventilation and gas exchange in the lungs under spirometric bicycle ergometry according to the "standard protocol" until the maximal oxygen consumption (MOC) was attained. The patients were examined 20-30 days, 3 and 6 months after operation. In accordance with the magnitude of the MOC expressed in metabolic equivalents (MET), all the patients were divided into 3 functional classes which corresponded roughly to the NYHA classification. It was revealed that with the same magnitude of the MOC the patients of the worst functional class had a lower production of CO2, a greater volume of the dead space and a higher level of minute ventilation. It is supposed that the described respiratory abnormalities are connected with enhanced ventilation of the poorly perfused alveoli, apparently because of venous congestion in the pulmonary capillaries. The characteristics of gas exchange and ventilation in the lungs investigated under the conditions of the "standard protocol" of spirometric bicycle ergometry objectively mark pump function of the heart and respiratory potentialities of the cardiorespiratory system, which might be the basis for the functional classification of the patients after cardiosurgical interventions.
在40例二尖瓣狭窄矫正术后患者的康复过程中，根据“标准方案”，在进行肺活量计自行车测力计测试时，对患者肺部的通气和气体交换进行了研究，直至达到最大耗氧量（MOC）。在术后20 - 30天、3个月和6个月对患者进行了检查。根据以代谢当量（MET）表示的MOC数值，将所有患者分为3个功能等级，这大致与纽约心脏协会（NYHA）的分类相对应。结果显示，在MOC数值相同的情况下，功能最差等级的患者二氧化碳产生量较低，无效腔容积较大，每分通气量较高。据推测，上述呼吸异常与灌注不良肺泡的通气增强有关，显然是由于肺毛细血管中的静脉淤血所致。在肺活量计自行车测力计“标准方案”条件下所研究的肺部气体交换和通气特征，客观地标志着心脏的泵功能和心肺系统的呼吸潜力，这可能是心脏外科手术后患者功能分类的基础。
