全胸腔镜肺叶切除术对患者动脉血气的影响

Effect of full thoracoscopic lobectomy on patients with arterial blood gas

目的探讨全胸腔镜肺叶切除手术对肺癌患者动脉血气的影响。方法选择肺叶切除术治疗的肺癌患者32例为研究对象。其中采用传统开胸手术者15例,全胸腔镜手术者17例,比较两组患者术前及术后动脉血气变化。结果术后第1天开胸组患者PaO2(68.30±3.37)mm Hg,胸腔镜组(81.37±5.51)mm Hg,差异有高度统计学意义(P<0.01);术后第3天开胸组患者PaO2(63.81±4.36)mm Hg,胸腔镜组(69.11±4.48)mm Hg,差异有高度统计学意义(P<0.01)。术后第3天,胸腔镜组PaO2显著下降,术后第7天恢复至正常水平;术后第1天和第3天开胸组PaO2均显著下降,术后第7天接近正常水平,但仍然低于术前(P<0.05)。术后第1天,两组BE水平均显著下降,与术前比较,差异有高度统计学意义(P<0.01)。术后第1天,开胸组SB(21.64±1.17)mmol/L,显著低于胸腔镜组(23.53±1.58)mmol/L(P<0.01),也低于开胸组术前(P<0.01);术前术后不同时间点胸腔镜组和开胸组Pa CO2、pH变化均不明显,不同时间点两组间比较差异无统计学意义(P>0.05)。结论与开胸术比较,全胸腔镜手术对肺癌患者术后动脉血气的影响相对较小。

Objective To discuss the effect of full thoracoscopic lobectomy on patients with arterial blood gas. Methods A total of 32 cases with lobectomy were selected as subjects. 15 cases were treated by thoracotomy, while 17 cases were treated by full thoracoscopic lobectomy. Levels of arterial blood gas before and after treatment were compared.Results The first day after operation, PaO2 of thoracotomy group was（68.30±3.37）mm Hg, and that of full thoracoscopic lobectomy group was（81.37±5.51）mm Hg, there were significant differences between two groups（P〈0.01）; The third day after operation, PaO2 of thoracotomy group was（63.81±4.36）mm Hg, and that of full thoracoscopic lobectomy group was（69.11±4.48）mm Hg, there was significant difference between two groups（P〈0.01）; the third day after operation, the PaO2 level of full thoracoscopic lobectomy decreased apparently, and returned to normal levels at the seventh day after operation; The first day and the third day after operation, PaO2 of thoracotomy group decreased apparently, and returned to normal levels at the seventh day after operation, but which was lower than before operation（P〈0.05）. The first day after operation, BE levels of two groups decreased apparently, which showed significant difference compared with be fore operation（P〈0.01）. The first day after operation, SB level of thoracotomy group was（21.64±1.17）mmol/L, which was lower than that of full thoracoscopic lobectomy group（23.53±1.58） mmol/L（P〈0.01）, and was lower than before operation（P〈0.01）; Pa CO2 and p H levels of two groups at different times changed little, and there was no significant difference（P〈0.05）. Conclusion Compared with thoracotomy, full thoracoscopic lobectomy shows little effect on arterial blood gas of patients with lung cancer.