Nomori H, Kobayashi R
Department of Surgery, Saiseikai Central Hospital, Tokyo, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1994 Sep;42(9):1272-5.
Postoperative pulmonary complications in patients undergoing thoracic surgery were examined along with their preoperative respiratory muscle strength and nutrition. Respiratory muscle strength was assessed by maximum inspiratory (MIP) and expiratory (MEP) pressures. Nutrition was assessed by serum levels of albumin and total cholesterol. The examined cases include 51 cases of lung tumors, 8 cases of mediastinal tumors, 9 cases of empyema, 3 cases of esophageal cancer, 2 cases of chest wall tumors, and 2 cases of giant bulla. Preoperative respiratory muscle training increased both MIP and MEP significantly (p < 0.01). Thirteen patients who had postoperative pulmonary complications had significantly lower values (p < 0.01), and did not show significant increases in either MIP or MEP even after training. The cases which experienced complications also showed significantly lower preoperative serum levels of albumin and total cholesterol (p < 0.01). Therefore, patients with respiratory muscle weakness and poor nutrition have a higher risk of postoperative pulmonary complications.
对接受胸外科手术患者的术后肺部并发症及其术前呼吸肌力量和营养状况进行了检查。通过最大吸气压力（MIP）和最大呼气压力（MEP）评估呼吸肌力量。通过血清白蛋白和总胆固醇水平评估营养状况。检查的病例包括51例肺肿瘤、8例纵隔肿瘤、9例脓胸、3例食管癌、2例胸壁肿瘤和2例巨大肺大疱。术前呼吸肌训练使MIP和MEP均显著增加（p<0.01）。13例发生术后肺部并发症的患者数值显著更低（p<0.01），即使训练后MIP或MEP也未显示出显著增加。发生并发症的病例术前血清白蛋白和总胆固醇水平也显著更低（p<0.01）。因此，呼吸肌无力和营养状况差的患者术后发生肺部并发症的风险更高。
