Fujita R A, Barnes G B
Department of Anesthesiology, Chapman Medical Center, Orange, California 92669, USA.
Ann Thorac Surg. 1996 Jul;62(1):251-7. doi: 10.1016/0003-4975(96)00227-5.
Both video-assisted thoracic surgery and open pneumonoplasty procedures have been used to achieve lung reduction in emphysema patients.
The surgical and hospital course of 339 patients with a mean forced expiratory volume in 1 second of 750 mL and a mean ratio of forced expiratory volume in 1 second to forced vital capacity of 35% undergoing video-assisted thoracic surgical laser pneumonoplasty was analyzed.
The incidence of myocardial infarctions was 0.9% and the hospital mortality rate was 4.1%.
Factors leading to increased morbidity and mortality were advanced age (65 years and greater, especially greater than 75 years), sex (men greater than women), carbon dioxide retention in the resting state (especially an arterial carbon dioxide tension greater than 55 mm Hg), forced expiratory volume in 1 second less than 700 mL for men and 500 mL for women, maximum voluntary ventilation less than 25% predicted, and a ratio of residual volume/total lung capacity greater than 60%.
电视辅助胸腔镜手术和开放性肺成形术均已用于肺气肿患者的肺减容。
分析了339例平均一秒用力呼气容积为750 mL、平均一秒用力呼气容积与用力肺活量之比为35%的患者接受电视辅助胸腔镜激光肺成形术的手术及住院过程。
心肌梗死发生率为0.9%，医院死亡率为4.1%。
导致发病率和死亡率增加的因素包括高龄（65岁及以上，尤其是75岁以上）、性别（男性高于女性）、静息状态下二氧化碳潴留（尤其是动脉血二氧化碳分压大于55 mmHg）、男性一秒用力呼气容积小于700 mL且女性小于500 mL、最大自主通气量小于预测值的25%以及残气量/肺总量之比大于60%。
