肺叶切除术中行膈神经压扎对肺功能的影响

The Effect on Lung Function in Patients with Lobectomy and Phrenic Nerve Compression

目的探讨肺叶切除术中膈神经压扎对肺功能的影响。方法40例行肺叶切除的患者,其中20例在行肺叶切除后加行膈神经压扎,另外20例未行膈神经压扎,分别测定其膈肌活动度、肺功能及术后发生并发症情况。结果两组患者比较,膈神经压扎组患者的膈肌活动度及肺功能均较未压扎组差,膈肌活动度分别为(1.17±0.41)cm和(2.11±0.42)cm(P<0.05);肺功能方面,压扎组患者肺活量、最大分钟通气量及第1秒用力呼气量分别为(70.25±5.25)%、(71.42±7.15)%和(65.50±4.51)%,未压扎组分别为(81.24±4.78)%、(80.87±8.65)%和(76.97±6.26)%,两组比较差异均有统计学意义(P<0.05)。但术后并发症的发生率,两组之间并无差别。结论肺叶切除时行膈神经压扎将进一步降低患者的肺功能,膈神经压扎在肺叶切除术中并非绝对必要。

Objective To investigate the effect on lung function in patients with lobectomy and phrenic nerve compression.Methods The diaphragmatic activity,lung function and postoperative complications were studied in 40 patients with lobectomy,20 cases received with phrenic nerve compression while another 20 cases received non-phrenic nerve compression.Results The diaphragmatic activity and lung function of patients with phrenic nerve compression were poorer than those without phrenic nerve compression.The diaphragmatic activity was（1.17±0.41） cm and（2.11±0.42） cm,respectively,P〈0.05.The pulmonary function of vital capacity,maximum minute ventilation,forced expiratory volume in 1st second were（70.25±5.25）%,（71.42±7.15）% and（65.50±4.51）% in patients with phrenic nerve compression and were significantly lower than those（81.24±4.78）%,（80.87±8.65）% and（76.97± 6.26）% in patients without phrenic nerve compression,P〈0.05.There was no difference between the two groups in the incidence of postoperative complications.Conclusion Lobectomy with phrenic nerve compression would decrease the patient＇s lung function.The phrenic nerve compression is not necessary in the lung resection.