Otaki M, Kawashima M, Yamaguchi A, Tamura H, Kitamura N
Department of Cardiovascular Surgery, Osaka National Hospital, Japan.
Kyobu Geka. 1993 Feb;46(2):117-20.
Twenty-four patients with cardiac cachexia associated with mitral valve disease were evaluated from the point of postoperative respiratory management. Our previous study suggested that preoperative intravenous hyperalimentation (IVH) had just a effect on postoperative respiratory management, but another study suggested that left atrial plication (LAP) for giant left atrium might improve the postoperative respiratory function. Therefore, four groups could be identified: (1) IVH group (17 patients), (2) No-IVH group (7 patients), (3) LAP group (6 patients), (4) No-LAP group (18 patients). The hospital mortality was 18% in IVH group and was not related to the postoperative respiratory distress. On the contrary, the mortality in No-IVH group was 57%, related to the postoperative respiratory distress. The mortality of LAP group was 67%, and was related to the respiratory distress except one patient. In No-LAP group which had undertaken preoperative IVH, the mortality was 17%. As a result, preoperative IVH therapy may consider to be a favorite procedure in order to get the good postoperative respiratory condition, but LAP itself would be suspicious for this purpose.
从术后呼吸管理的角度对24例与二尖瓣疾病相关的心脏恶病质患者进行了评估。我们之前的研究表明，术前静脉高营养（IVH）对术后呼吸管理仅有一定作用，但另一项研究表明，针对巨大左心房的左心房折叠术（LAP）可能会改善术后呼吸功能。因此，可以分为四组：（1）IVH组（17例患者），（2）非IVH组（7例患者），（3）LAP组（6例患者），（4）非LAP组（18例患者）。IVH组的医院死亡率为18%，且与术后呼吸窘迫无关。相反，非IVH组的死亡率为57%，与术后呼吸窘迫有关。LAP组的死亡率为67%，除1例患者外均与呼吸窘迫有关。在接受术前IVH的非LAP组中，死亡率为17%。因此，术前IVH治疗可能被认为是获得良好术后呼吸状况的一种理想方法，但就这一目的而言，LAP本身可能存在疑问。
