Minamiya Y, Abo S, Kitamura M, Hashimoto M, Izumi K, Shikama T, Sato H, Shimada T, Kimura K
Second Department of Surgery, Akita University School of Medicine, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1993 Mar;41(3):396-402.
We evaluated the right ventricular function in pre- and post-operative esophageal cancer patients who had no complications after surgery by measurement of cardiopulmonary hemodynamics, right ventricular ejection fraction (RVEF) and right ventricular end-diastolic volume index (RVEDVI) using Swan-Ganz catheter and the thermodilution technique. The measurement of RVEF, RVEDVI and other cardiopulmonary hemodynamics were performed from the preoperative day to the 3rd postoperative day. The values of RVEF were stable about 40% from preoperative day to 3rd. RVEDVI was varied at 93.6 +/- 26.3 ml/m2 (preoperative day), 83.6 +/- 15.0 ml/m2 (after surgery), 70.2 +/- 10.6 mg/m2 (morning of the 1st POD), 95.6 +/- 19.4 ml/m2 (evening of the 1st POD), 103.2 +/- 17.9 m/lm2 (morning of the 2nd POD), 1108.3 +/- 14.2 ml/m2 (evening of the 2nd POD) and 112.4 +/- 31.0 ml/m2 (morning of the 3rd POD). The values of RVEDVI on the morning of the 1st POD were statistically lower than those at other times (p < 0.05). The values of RVEDVI were not correlated with mean pulmonary arterial pressure and pulmonary arteriolar resistance which were the afterload of the right ventricle. These data suggest that the right ventricular function of the patients who underwent esophagectomy with no complication does not change and that the changes of RVEDVI are influenced by the preload of the right ventricle.
我们通过使用Swan-Ganz导管和热稀释技术测量心肺血流动力学、右心室射血分数(RVEF)和右心室舒张末期容积指数(RVEDVI),对术后无并发症的食管癌患者术前和术后的右心室功能进行了评估。从术前一天到术后第三天对RVEF、RVEDVI和其他心肺血流动力学进行测量。从术前一天到第三天,RVEF值稳定在约40%。RVEDVI变化如下:93.6±26.3 ml/m²(术前一天)、83.6±15.0 ml/m²(术后)、70.2±10.6 mg/m²(术后第一天上午)、95.6±19.4 ml/m²(术后第一天晚上)、103.2±17.9 m/lm²(术后第二天上午)、1108.3±14.2 ml/m²(术后第二天晚上)和112.4±31.0 ml/m²(术后第三天上午)。术后第一天上午的RVEDVI值在统计学上低于其他时间的值(p<0.05)。RVEDVI值与作为右心室后负荷的平均肺动脉压和肺小动脉阻力无关。这些数据表明,无并发症接受食管切除术患者的右心室功能没有改变,RVEDVI的变化受右心室前负荷的影响。