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[儿童和青少年肺动脉瓣狭窄术后心肺功能研究(作者译)]

[Postoperative cardiopulmonary function studies in children and adolescents with pulmonary valvular stenosis (author's transl)].

作者信息

Bastanier C, Kaltwasser B, Mocellin R

出版信息

Z Kardiol. 1977 Oct;66(10):587-93.

PMID:919670
Abstract

Cardiopulmonary function studies at rest and during submaximal and maximal exercise were performed in 20 children and adolescents who had undergone valvotomy of a pulmonary valvular stenosis. Maximal oxygen uptake of the patients was 90%, stroke volume 95% of expected values. There was a strong correlation between stroke volume and maximal oxygen uptake. Mean right ventricular systolic pressure at rest was 39 mm Hg and increased to 60 mm Hg at a submaximal load corresponding to 1 1/2 Watt/kg body weight. There was no correlation between right ventricular systolic pressure on the one hand and maximal oxygen uptake, stroke volume and pulmonry valve resistance, on the other hand. It is concluded, that the importance of maximal oxygen uptake as the equivalent of cardiovascular performance capacity and of stroke volume alone as a main parameter of cardiac function may not be overestimated regarding their value in the assessment of the surgical result. A reoperation must be considered when a distinctly elevated right ventricular pressure at rest shows an additional overproportional increase at exercise in the presence of a decreasing stroke volume. This was the case in 3 of our 20 patients.

摘要

对20名接受过肺动脉瓣狭窄瓣膜切开术的儿童和青少年进行了静息状态以及次最大运动量和最大运动量运动期间的心肺功能研究。患者的最大摄氧量为预期值的90%,每搏输出量为预期值的95%。每搏输出量与最大摄氧量之间存在很强的相关性。静息时平均右心室收缩压为39毫米汞柱,在相当于1.5瓦/千克体重的次最大负荷时升至60毫米汞柱。一方面,右心室收缩压与另一方面的最大摄氧量、每搏输出量和肺动脉瓣阻力之间没有相关性。得出的结论是,就其在评估手术结果中的价值而言,最大摄氧量作为心血管功能能力的等效指标以及仅将每搏输出量作为心脏功能的主要参数的重要性可能不应被高估。当静息时右心室压力明显升高,且在每搏输出量减少的情况下运动时出现额外的不成比例增加时,必须考虑再次手术。我们的20名患者中有3例是这种情况。

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