心脏瓣膜手术期间肺通气功能的变化

Changes of pulmonary ventilatory function during open heart surgery

目的:观测体外循环心脏瓣膜手术期间肺通气功能的变化。方法:对34例择期心脏手术病人在麻醉手术期间及体外循环前后,采用旁气流呼吸监测方法测定通气功能的变化。结果:P_(peak)和P_(plat)在CPB后60分内无显著性变化,但关胸术毕时明显增高(P<0.05);V_(1.0)在CPB后持续减低(P<0.01);肺总静态顺应性在CPB后的60分内有所增加(P<0.05),在关胸后迅速回复至基础值水平。VO_2测定显示,CPB前均明显降低(P<0.05),CPB后恢复至基础值水平。结论:心脏瓣膜手术CPB后肺通气功能有一定程度损伤。

Objective: To observe the changes of the pulmonary ventilatory function during cardiac valve operation under cardiopulmonary bypass(CPB). Method: Thirty-four patients undergoing cardiac valve operation were selected. The pulmonary function was measured with side stream spirometer. Result: P_(peak) and P_(plat) did not have any significant changes within 60 min after CPB, but increased significantly at the end of surgery and after closure of sternum(P<0.05). V_(1.0) was persistently decreased after CPB (P<0.01), The total static compliance increased during 60 min after CPB (P<0.05) but returned to the baseline rapidly after closure of the sternum. The oxygen consumption(VO_2) decreased after sternotomy and before CPB(P<0.05), returned to the baseline after CPB. Conclusion: The pulmonary ventilatory function is reduced to some degree after CPB and cardiac valve operation