Nishimura H, Haniuda M, Morimoto M, Kubo K
Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Ann Thorac Surg. 1993 Jun;55(6):1477-84. doi: 10.1016/0003-4975(93)91091-z.
The effects of pulmonary lobectomy on cardiopulmonary function were investigated in 9 patients with lung cancer. Hemodynamic studies at rest and during exercise were performed before and 4 to 6 months after the operation. Differences in hemodynamics between before and after operation were observed with respect to heart rate, pulmonary arterial pressure, pulmonary vascular resistance index, and stroke volume index. Heart rate, pulmonary arterial pressure, and pulmonary vascular resistance index were significantly increased after operation, whereas stroke volume index was significantly decreased. It is thought that cardiac index was preserved by the increase in heart rate despite a decrease in stroke volume index associated with the decreased pulmonary vascular bed after the operation. When driving pressure and cardiac index were studied after operation, the pressure at rest and during exercise was higher, and the pressure-flow curve increased more steeply, as compared with the preoperative values. These results suggest a significant deterioration in cardiopulmonary function after lobectomy. As the patient characteristics were heterogeneous (five lobectomies and four bilobectomies), and their findings are limited, additional studies may be necessary in the future.
对9例肺癌患者进行了肺叶切除术对心肺功能影响的研究。在手术前以及术后4至6个月，分别进行了静息和运动状态下的血流动力学研究。观察了手术前后心率、肺动脉压、肺血管阻力指数和每搏量指数的血流动力学差异。术后心率、肺动脉压和肺血管阻力指数显著升高，而每搏量指数显著降低。据认为，尽管手术后肺血管床减少导致每搏量指数下降，但心率增加使心脏指数得以维持。术后研究驱动压力和心脏指数时，与术前值相比，静息和运动时的压力更高，压力-流量曲线上升更陡峭。这些结果表明肺叶切除术后心肺功能显著恶化。由于患者特征各异（5例肺叶切除术和4例双叶切除术），且研究结果有限，未来可能需要进行更多研究。
