肺癌患者围术期换气功能的研究

Study on gas exchange of the patients with lung cancer in perioperation

目的研究肺癌患者围术期换气功能的改变规律及影响机制。方法用氧合指数（Ｐ／Ｆ）、动脉肺泡氧分压比（ａ／Ａ）、动脉血氧饱和度５０％的氧分压（Ｐ５０Ｏ２）、动脉血二氧化碳分压（ＰａＣＯ２）４项指标对６８例５０岁以上男性肺癌患者分别于术前、术后即日、１、２、３、７日围术期换气功能进行监测。结果肺癌术后３日内Ｐ／Ｆ、ａ／Ａ较术前显著降低（Ｐ＜０．０１）；ＰａＣＯ２、Ｐ５０Ｏ２术后即日较术前显著增加（Ｐ＜０．０１）；术后２日内全肺切除氧合功能降低大于肺叶切除（Ｐ＜０．０５）；低肺功能患者术后换气及通气功能障碍较肺功能正常者显著（Ｐ＜０．０５）。结论肺癌术后３日换气功能明显减退，尤以氧合功能降低显著。应重点监测氧合功能变化，加强全肺及低肺功能患者的换气功能监测。

Objective To study changes of gas exchange in perioperative patients with lung cancer. Method Indices including P/F,a/A, P 50 O 2 and PaCO 2 on gas exchange in 68 male patients(50 78y) with lung caner were monitored on preoperative day 1 2 3 and postopertive day 7. Result Comparing with preoperation data P/F a/A decreased significantly in 3 days( P <0.01) and PaCO 2 P 50 O 2 incresesd significantly on the day after operation ( P <0.01), especially in the group of pneumonectomy and abnormal ventilation,hypoxemia measured in preoperation. Conclusion The gas exchange of the patients with lung caner reduced significantly in postoperative 3 days.