上腹部手术对小气道功能的影响

Effects of upper abdominal surgery under different anesthesia on Small airway function

通过监测用力呼气中期流速（ＭＭＦ）和呼出２５％、５０％、７５％用力肺活量（ＦＶＣ）时瞬时呼气流速（ＦＥＦ）２５％、ＦＥＦ５０％和ＦＥＦ７５％等指标，对２５例不同麻醉方法下（全麻、硬膜外阻滞）行上腹部手术患者围术期小气道功能进行了连续观察。结果显示，术后４小时ＭＭＦ为术前的３２．７％，术后第７天为术前的６８．２％。表明上腹部手术后小气道功能严重减退。

The abnornlalities of pulmonary function occurs frequently in the patients after upper abdominal surgery(UAS). The aim of this study was to evaluate the small airway function (SAF) after UAS. Twentyufive patients,aged between 29 and 69 years,ASA grade Ⅰ to Ⅱ,after having undergone elective UAS with combined general anesthesia (n=8) or epidural block (n=17),served as the subjects. A computerized spirometer was applied to measuring the maximal midexpiratory flow (MMF),and forced expiratory flows (FFF) at 25 %, 50 % and 75 % of forced vital capacity (FVC ), as the parameters indicating SAF, before anesthesia,at 4, 8 and 12 hours postoperatively,and every morning during the first seven postoperative days,respectively. The results showed that as compared with preoperative values,the postoperative MMFs and FEFs at 25%,50% and 75% of FVC were decreased significantly (PRO' 05),moreover,as time went on postoperatively,the values increased gradually. The MMFs of patients with epidural block were higher than those with general anesthesia during the first postoperativc 3 days (P<0. 05). So we suggest that the SAF may be impaired seriously after UAS,especially under combined gerenal anesthesia and in early postoperative duration.