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[旋转胸肌皮瓣手术治疗心脏手术后胸骨伤口并发症患者的肺功能情况]

[Involvement of pulmonary function in patients treated with rotated chest muscle flap surgery for the treatment of sternal wound complications after heart surgery].

作者信息

Blacher C, Leães P E, Parisotto A, Bendl A L, Boeira J, Lucchese F A

机构信息

Hospital São Francisco da Irmandade Santa Casa de Miscricórdia de Porto Alegre.

出版信息

Arq Bras Cardiol. 1996 Oct;67(4):243-7.

PMID:9181722
Abstract

PURPOSE

To evaluate pulmonary function of patients submitted to muscle flap for treatment of mediastinitis.

METHODS

Fifteen patients operated with the muscle flap technique were compared with 26 consecutive patients submitted to heart surgery with extracorporeal circulation, that did not present wound complications. Both groups were evaluated for age, sex, body weight, height, surgery, forced vital capacity (FVC), forced expiratory volume in first second (FEV1) and the relation (FEV1/FVC) in absolute and percentual values, espirometry conclusions and clinical evidences of lung disease.

RESULTS

There was no statistical difference between preoperative and postoperative period for FVC (p = 0.98), FEV1 (p = 0.68) and FEV1/FVC (p = 0.30) in the group with no sternal complications. In the control group, the median of FVC was 3907 +/- 1053.25 and in the study group was 2818 +/- 766.86 in absolute values (p = 0.0015). The median of FEV1, in the control group, was 2995 +/- 855.68 and in the study group was 2232 +/- 617.68 in absolute values (p = 0.0046). There was statistical difference, between groups, in FVC (104.78 +/- 21.73 and 82.04 +/- 21.16) and FEV1 (99 +/- 22.67 and 79.04 +/- 19.17) in percentual (p = 0.0026 and 0.0067) values. There was no statistical difference for the ratio FEV1/FVC. The study group had five patients diagnosed as having restrictive ventilatory insufficiency by espirometry against none in the control group (p = 0.0031).

CONCLUSION

Patients with infectious complications of sternum and mediastinum, treated surgically with muscle flap rotation may present restrictive pulmonary insufficiency in moderate degree, that must be considered in this situation.

摘要

目的

评估接受肌瓣治疗纵隔炎患者的肺功能。

方法

将15例行肌瓣技术手术的患者与26例连续接受体外循环心脏手术且无伤口并发症的患者进行比较。对两组患者的年龄、性别、体重、身高、手术情况、用力肺活量(FVC)、第1秒用力呼气量(FEV1)以及两者的比值(FEV1/FVC)的绝对值和百分比值、肺量计结论及肺部疾病的临床证据进行评估。

结果

无胸骨并发症组术前和术后FVC(p = 0.98)、FEV1(p = 0.68)和FEV1/FVC(p = 0.30)无统计学差异。对照组FVC绝对值中位数为3907±1053.25,研究组为2818±766.86(p = 0.0015)。对照组FEV1绝对值中位数为2995±855.68,研究组为2232±617.68(p = 0.0046)。两组间FVC(104.78±21.73和82.04±21.16)和FEV1(99±22.67和79.04±19.17)的百分比值有统计学差异(p = 0.0026和0.0067)。FEV1/FVC比值无统计学差异。研究组有5例患者经肺量计诊断为限制性通气功能不全,而对照组无(p = 0.0031)。

结论

胸骨和纵隔感染并发症患者,采用肌瓣旋转手术治疗可能会出现中度限制性肺功能不全,对此情况必须加以考虑。

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