风湿性心脏病二尖瓣狭窄患者肺功能损害的临床分析

THE CLINICAL ANALYSIS OF PREOPERATIVE LUNG FUNCTION IN PATIENTS OF RHEUMATIC HEART DISEASE WITH MITRAL STENOSIS

对21例风湿性心脏病二尖瓣狭窄患者术前肺功能进行了分析。结果表明,肺功能损害以限制性通气障碍为主(57.1％)。异常肺功能组术前PO_2明显低于正常组(P<0.05),左房内径与肺活量(VC)最大通气量(MVV)呈负相关(r=-0.74,P<0.01;r=-0.72,P<0.05)。作者认为,心功能异常是导致肺功能损害的重要原因,根据左房内径可对术前肺功能作出初步佐测。应当强调,手术解除二尖瓣狭窄及降低肺血管阻力是改善肺功能的根本途径。

The preoperative lung functions in 21 cases of rheumatic heart disease with mitral stenosis were analysed. The results showed that restrictive ventilative disorder was the main type of the longs' functional impairment ( 12/21). Blood-gas analysis indicated that the P02 in those with abnormal lung function was significantly lower than normal(p<0.05 ) The diameter of left atrium was negatively correlated with vital capicity ( VC ) and maximal ventilative volume ( MVV ) respectively (r=-0.74, P<0.01; r=-0.72, P<0.05). We conclude that the functional impairment of the lungs is primarily attributed to the cardiac dysfunction,and the lung function can be appraised preoper-atively according to the left atrial diameter.Hence it deserves emphasis that in order to improve the lung function, an operation to relieve the atenosis of mitral valve and decrease the pulmonary vascular resistance should be the radical apporach.