胸腔镜与传统开胸肺叶切除术对心肺功能的影响.docVIP

论著 胸腔镜与传统开胸肺叶切除术对心肺功能的影响 税跃平 吴云飞（646000 泸州，泸州医学院附属医院胸心外科） [摘要] 目的 探讨经胸腔镜和传统肺叶切除对心肺功能的影响 方法 2008年6月至2009年6月我科36例行肺叶切除术分为经胸腔镜和传统开胸2组，每组18例。在心肺运动试验MVV及心功能指标SV、EF、FS、MVCF与传统开胸组相比显著增加（P0.05）。结论 胸腔镜肺叶切除组术后对心肺功能指标影响较小，明显优于传统开胸组。在CPET下用肺功能仪和心脏彩超检测术后心肺功能指标更好地反映了心肺功能的储备，更科学、更客观地评价个体的心肺功能，值得临床应用。 [关键词] 胸腔镜；肺叶切除；心肺运动试验Effect of radical resection of pulmonary lobectomy via thoracoscopy or conventional thoracotomy on cardiopulmonary function: report of 36 cases Shuiyueping, Wuyunfei (Department of Thoracic and Cardiovascular Surgery , the Affiliated Hospital of luzhou medical college,luzhou,646000,china) [Abstract] Objective to investiment the effect of thoracoscopy or conventional thoracotomy radical resection of pulmonary lobectomy on cardiopulmonary function in patients .Methods thirty-six patients with Lung pathological change hospitalized in our department from june 2008 to june 2009 were equally divided into thoracoscopy group and conventional thoracotomy group. cardio-pulmonary function indicators of 3 ,6 ,12, months after surgery was measured with spirometer and echocardiography under cardiopulmonary exercise test Result postoperative cardio-pulmonary function indicators in thoracoscopy group was more progressive in above-mentioned time periods ,compared with conventional thoracotomy group (P 0. 05). Conclusion thoracoscopy group showed a more remardable impairment in cardio-pulmonary function than that in conventional thoracotomy group.measuring postoperative cardio-pulmonary function indicators reflect cardiopulmonary function reserve more better with spirometer and Echocardiography under cardiopulmonary exercise test. It is a more objective and scientific method of valuating individual cardio-pulmonary function,deserving to clinical application. [Key words] thoracoscopy; pulmonary lobectomy; cardiopulmonary exercise test; cardio-pulmonary function 随着胸腔镜技术的迅猛发展与日臻成熟，胸外科已经进入了微创时代。在为患者解除病痛的同时，尽可能减轻手术创伤对心肺功能的影响。多数学者认为胸腔镜术式对术后心肺功能影响较小。心肺运动试验(cardiopulmonary exercise