Sekine Y, Yamaguchi Y, Fujisawa T, Ogawa T, Urabe N, Saitoh Y, Takeda T
Department of Surgery, Chiba University, School of Medicine, Japan.
Kyobu Geka. 1993 Nov;46(12):997-1001; discussion 1001-3.
The influence of thoracotomy on respiratory function was examined in 49 patients: 22 with intercostal thoracotomy without lung resection (ICT), 11 with partial lung resection (PLR) and 16 with median sternotomy (MST). Respiratory function (FVC, FEV1.0 and FEV1.0%) was measured preoperatively, in the early stage (14 days) and in the stable stage (after 3 months) postoperatively. In each group, the FVC and FEV1.0 were decreased to 70-80% of preoperative respiratory function in the early stage and rose to 90-95% in the stable stage. There were no significant differences among the groups. FEV1.0% did not vary in the different stages in any of the three groups. The ICT group was classified according to the type of skin incision (axillary incision (AI), anterolateral incision (ALI) and posterolateral incision (PLI)). FVC and FEV1.0 in the ALI subgroup were higher (p < 0.05) than in the PLI subgroup in the early stage. These results suggest that the selection of the skin incision is important for preserving respiratory function.
对49例患者进行了开胸手术对呼吸功能影响的研究：22例接受不进行肺切除的肋间开胸手术（ICT），11例接受部分肺切除（PLR），16例接受正中胸骨切开术（MST）。在术前、术后早期（14天）和稳定期（3个月后）测量呼吸功能（用力肺活量（FVC）、第1秒用力呼气量（FEV1.0）和FEV1.0%）。每组中，FVC和FEV1.0在术后早期降至术前呼吸功能的70 - 80%，在稳定期升至90 - 95%。各组之间无显著差异。三组中任何一组的FEV1.0%在不同阶段均无变化。ICT组根据皮肤切口类型进行分类（腋窝切口（AI）、前外侧切口（ALI）和后外侧切口（PLI））。ALI亚组的FVC和FEV1.0在早期高于PLI亚组（p < 0.05）。这些结果表明，皮肤切口的选择对维持呼吸功能很重要。
