超声心动图评价肺切除术后右心重构及右心功能的变化

Right heart remodeling and right heart function change after pulmonary resection evaluated by echocardiography

目的:探讨超声心动图技术评价的肺切除术后右心重构及右心功能的变化。方法:利用超声心动图技术对50例肺叶切除术患者进行检测。评价术前、术后右室结构及右心功能变化。结果:(1)肺切除术后7d及30d右室前游离壁厚度,右室射血分数同术前比较无显著变化;(2)与术前比较,术后7d肺动脉收缩压[PASP,(20.52±2.46)mmHg比(49.65±2.17)mmHg]、肺动脉舒张压[PADP,(10.82±2.04)mmHg比21.93±1.26)mmHg]、肺动脉平均压[PAMP,(13.78±3.67)mmHg比(26.67±3.28)mmHg],肺血管阻力[PVR,(187.69±12.46)dyn.s.cm-1比(368.72±11.94)dyn.s.cm-1]均显著升高(P均<0.05);术后30d上述指标恢复正常;(3)与术前比较,右室术后7dTei指数明显升高[(0.36±0.05)比(0.69±0.13),P=0.04],术后30dTei指数恢复正常(P=0.20)。结论:肺切除术后7d肺动脉收缩压、舒张压、平均压均较术前显著升高,肺血管阻力显著增加。术后30d上述指标恢复到术前。肺切除术后7d及30d无右心室重构发生。

Objective：To evaluate right heart remodeling and right heart function change after pulmonary resection by echocardiography （ECG） .Methods：A total of 50 patients undergoing pneumonectomy received ECG examination to evaluate right ventricular structure and right heart function change before and after partial pulmonary resection .Results：（1） Compared with before operation , there were no significant changes in right ventricular anterior free wall thickness ,right ventricular ejection fraction on 7d and 30d after operation;（2） Compared with before treatment , there were significant rise in pulmonary artery systolic pressure [PASP ,（20.52 ± 2.46） mmHg vs .（49.65 ± 2.17） mmHg] ,pulmonary artery diastolic pressure [PADP ,（10.82 ± 2.04） mmHg vs .（21.93 ± 1.26） mmHg] and pul-monary artery mean pressure [PAMP ,（13.78 ± 3.67） mmHg vs .（26.67 ± 3.28） mmHg] ,and significant rise in pulmonary vascular resistance [PVR ,（187.69 ± 12.46） dyn .s .cm^-1 vs .（368.72 ± 11.94） dyn .s .cm^-1 ] on 7d after pulmonary resection , P〈0.05 all;all above indexes recovered to normal on 30d after treatment ;（3） Compared with before operation ,right ventricular Tei index significantly rose [ （0.36 ± 0.05） vs .（0.69 ± 0.13） , P=0.04] on 7d after operation ,the Tei index recovered to normal on 30d after treatment ,P=0.20. Conclusion：Compared with before operation , the PASP ,PADP and PAMP significantly rise on 7d after operation ,they recover to normal on 30d after treatment ;there are no significant change in right ventricular structure .