Yamamoto R, Inoue K, Hori T, Miyamoto Y, Takehara S, Kaji M, Kinoshita H
Second Department of Surgery, Osaka City University Medical School, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1994 Aug;42(8):1178-83.
Serum zinc and copper were measured in 47 patients undergoing pulmonary operation. They were divided into two groups according to the extent of the operation. Group A consisted of 32 patients with lung cancer, in whom lobectomy with lymphadenectomy was performed through the postero-lateral thoracotomy. Group B consisted of 15 patients with benign pulmonary lesion or metastatic pulmonary tumor, in whom wedge resection was performed through the axillary thoracotomy. In Group A, the serum zinc concentration most decreased 6 hours after surgery. It returned to normal level in 5-7 days and to the preoperative level within 14 days. In Group B, the maximal fall in serum zinc was at 3 hours after operation. Restoration to normal level was at 2nd postoperative day and to the preoperative level was at 5th postoperative day. The differences in serum zinc between two groups were significant (p < 0.05) from just after operation to 4th postoperative day. The degree of maximal decrease in serum zinc in Group A was more than that in Group B. Blood loss, operation time and pulmonary function did not influenced the change of serum zinc concentration in our series. These results show that degree and duration of reduction in serum zinc depends on the surgical trauma. On the other hand, no significant difference in serum copper levels was observed between two groups. The influence of pre- and post-operative pneumonia on serum zinc concentrations were followed in 3 patients. Fall and rise in serum zinc levels coincided with manifestation of and recovery from pneumonia.(ABSTRACT TRUNCATED AT 250 WORDS)
对47例接受肺部手术的患者测定了血清锌和铜水平。根据手术范围将他们分为两组。A组由32例肺癌患者组成,通过后外侧开胸进行肺叶切除及淋巴结清扫术。B组由15例良性肺部病变或肺转移瘤患者组成,通过腋下开胸进行楔形切除术。在A组中,血清锌浓度在术后6小时下降最为明显。5 - 7天恢复至正常水平,14天内恢复至术前水平。在B组中,血清锌的最大降幅出现在术后3小时。术后第2天恢复至正常水平,术后第5天恢复至术前水平。从术后即刻至术后第4天,两组血清锌水平差异有统计学意义(p < 0.05)。A组血清锌最大降幅程度大于B组。在我们的研究系列中,失血量、手术时间和肺功能并未影响血清锌浓度的变化。这些结果表明,血清锌降低的程度和持续时间取决于手术创伤。另一方面,两组血清铜水平未观察到显著差异。对3例患者随访了术前和术后肺炎对血清锌浓度的影响。血清锌水平的下降和上升与肺炎的出现及恢复相一致。(摘要截选至250字)