肥胖病人上腹部手术后肺小气道功能的改变

Variations of Small Airway Function in the Obese Patientsafter Upper Abdominal Surgery

目的：监测１０例肥胖病人硬膜外麻醉上腹部手术后肺小气道功能。方法：用ＡＳ－３００型电脑肺功能仪测定。结果：用力呼气中期流速（ＭＭＦ）及用力肺活量位时呼气流速（ＦＥＦ）于术后均显著下降。特别是术后１２ｈ，ＭＭＦ、ＦＥＦ５０％及ＦＥＦ２５％分别下降到术前水平的３５．１０％、３２．４３％和３４．２９％，直到术后第７天也只恢复到术前水平的６５．４０％、６１．８９％和５９．０９％（Ｐ＜０．０１）。结论：肥胖病人上腹部手术后肺小气道功能损害严重，且恢复缓慢。

Objective and Methods: The small airway function (SAF) was monitored in 10 obese patients after upper abdominal surgery (UAS) under epidural blockade. Results: The maximal midexpiratory flow (MMF), and forced expiratory flows (FEF) at 75%,50% and 25% of forced vital capacity (FVC) were significantly decreased after operation, especially at 12h after operation, MMF, FEF 50% and FEF 25% reached 3510%, 3243% and 3429% of the preoperative values respectively (P<001). The values only reached 6540%,6189% and 5909% of the preoprative level on the seventh postoperative day. The changes in the obese group were all significant as compared with that in the control group (P<001). Conclusion: The SAF is impaired seriously in the obese patients after UAS and the recovery is slow.