肺切除手术对肺癌患者右心功能的影响分析

Impact Analysis of Pneumonectomy for Lung Cancer Surgery Patients Right Heart Function

目的:对肺切除手术对肺癌患者右心功能的影响进行分析,以找出更好的治疗途径。方法:随机选取我院接受肺切除术的35例肺癌患者,按照手术方式的不同分为肺叶切除组和全肺切除组。分别在术前和术后的第3天和第8天时检测CVP和PaO2,同步记录心电图并测得心率(HR),然后进行测右心室舒张末期容积指数和右心室射血分数以及肺动脉平均压。结果:两组手术前后CVP基本维持稳定,术后第3天,两组肺动脉平均压和心率均较术前显著增加,右心室舒张末期容积指数较术前显著增加,右心室射血分数较术前显著降低,全肺切除组各项指标变化均较肺叶切除组更显著,且PaO2较术前显著下降,但是肺叶切除组术后PaO2与术前差异不明显。术后第8天时,肺叶切除组各项指标均恢复至术前水平,全肺切除组则与术前比较仍存在差异。结论:肺切除手术尤其是全肺切除可引起右心功能降低,应尽可能采取肺叶切除,以增加术后成功率。

Objective：Pneumonectomy for lung cancer surgery for patients with the influence of right heart function analysis,in order to find better ways of treatment.Methods：Our randomly selected accept of pneumonectomy 35 patients with lung cancer,according to the different methods of operation into lobectomy group and pneumonectomy group.Respectively in preoperative and postoperative 3 days and days and PaO2 CVP 8 detection,synchronous ecg and record the heart rate（HR）,and then the right ventricular end-diastolic olume index and right ventricular ejection fraction and pulmonary artery pressure on average.Results：Two groups before and after surgery CVP basic maintain stable,postoperative day 3,two groups of pulmonary artery pressure and heart rate than that on average preoperative increased significantly,right ventricular end-diastolic olume indices were improved significantly increased,right ventricular ejection fraction were improved significantly reduced,pneumonectomy group which is the index of change lobectomy more significant group,and PaO2 were improved significantly,but lobectomy group began PaO2 preoperative and no obvious difference.8 days after,lobectomy group of each index all return to a preoperative level,pneumonectomy with preoperative group,is still exist differences.Conclusion：Lung surgery especially pneumonectomy can cause right heart function is reduced,should as far as possible to take lobectomy,to increase the success rate.