经皮二尖瓣球囊成形术后肺功能评估

Evaluation of Pulmonary Function After Percutaneuous Balloon Mitral Valvuloplasty

为了解经皮二尖瓣球囊成形术(PBMV)后风湿性二尖瓣狭窄患者肺功能的变化,对38例病人在PBMV术前及术后24～48小时内作肺功能检查。结果显示PBMV术后二尖瓣口面积显著增加,左房压下降(P<0.01),随之肺通气功能及小气道功能一系列指标亦明显改善(P<0.05)。术后肺动脉收缩压降低的程度△PASP)与1秒时间肺活量增加的程度(△FEV_1)呈正相关(r=0.74,P<0.01),术前心功能Ⅲ～N级患者,术后其最大通气量(MVV)明显增大,优于术前心功能Ⅱ级患者(P<0.001)。研究提示:PBMV术后24～48小时内肺功能即可明显改善,术前心功能越差,术后肺功能改善越明显,肺功能检查可作为一项评定PB-MV手术效果的辅助手段。

To evaluate the changes of pulmonary function in patients with rheumatic mitral stenosis after percutaneuous balloon mitral valvuloplasty(PBMV). Examination of pulmonary function was performed in 38 patients before and within 24 to 48 hours after PBMV. Results showed the mitral valve area was markedly enlarged ( P <0. 01),left atrium pressure decreased( P <0. 01),and the ventilatory function of lungs and small air passages improved immediately( P <0. 05). There was a positive correlationship between the changes of pulmonary artery systolic pressure(△PASP) and forced expiratory volumein one second(△FEV1 )( r =0. 74, P <0. 01)). The increasement of maximal voluntary ventilation (MVV) in patients with cardiac function of grade Ⅲ-Ⅳ (NYHA)was significantly larger than that of patients with grade Ⅱ( P <0. 01). insummary.pulmonary function is improved within 24 to 48 hours after PBMV. The worse the cardiac function was,the more obviously the pulmonary function was improved. Examination of pulmonary function could act as an auxiliary method to evaluate the effect of PBMV.