术前心功能检查在胸部肿瘤外科手术治疗中的意义  

Effect of Preoperative Cardiac Function Examination on Thoracic Tumor Surgery

作　　者：李鉴[1] 张德超 郑蓉 严少平 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤研究所、肿瘤医院胸外科主任医师,北京100021 [2]不详

出　　处：《中国现代手术学杂志》2006年第1期2-5,共4页Chinese Journal of Modern Operative Surgery

摘　　要：目的分析胸部肿瘤患者术前心功能的状况及其对术后恢复的影响。方法前瞻性随机抽取166例胸部肿瘤患者,进行术前左心室射血分数(leftventricularejectionfraction,LVEF)检查并分析其特点。同时,采用Logistic回归分析LVEF对术后发热≥38℃天数、术后行气管镜吸痰、住院天数,并发症发生情况和出院时状况的影响。结果①左心室各部位射血分数(ejectionfraction,EF)由大到小依次为:下壁、侧壁、心尖部、间壁和下间壁。②除间壁外,其他各部位EF及LVEF,运动后较运动前值均有显著增加(P<0.05)。③心电图显著异常组和合并心脏疾病史患者,运动后LVEF无显著提高(P>0.05)。④心率越慢,LVEF值越大(P<0.05)。⑤运动前LVEF、FEV1%和年龄对术后发热天数(≥38℃)影响最大。运动前LVEF对术后肺并发症的发生影响最大。⑥LVEF与术后其他并发症发生、术后吸痰、住院时间和出院时状况无明显相关性。结论①心脏异常时,LVEF增加困难。②LVEF仅影响术后肺并发症和发热天数,对术后吸痰、住院时间、出院时状况等其他术后恢复情况影响不大。Objective To investigate the preoperative cardiac function of thoracic tumor patients and its role in the postoperative recovery. Method 166 cases of thoracic tumor patients selected randomly undertaken the left ventricular ejection fraction（LVEF） preoperatively, the data were characterized and statistically analyzed using Logistic regression with regard to the association between LVEF and the persisting days of fever over 38℃, times of bronchoscopic suction of sputum, hospitalized duration, complication rate and the condition at the time of discharge. Result ①The ejection fraction of different area of left ventricle were ranked from high to low as inferior, lateral wall, apex cordis, sepal and inferoseptal wall in turn. ②The EF and LVEF of those areas were significantly increased after sport except sepal （ P 〈 0.05 ）. ③There was no significant increase of LVEF in the group of the patient with abnormal electrocardiogram and with concomitant heart disease（P 〉 0. 05）. ④There was a significant negative correlation between heart rate and LVEF （ P 〈 0.05 ）. ⑤ LVEF prior to sport, FEV1% and age demonstrate the most significant effect on the persisting days of fever over 38℃. LVEF prior to sport has the most effect on the postoperative pulmonary complication. ⑥No significant correlation between LVEF and other complications, times of bronchoscopical suction of sputum, hospitalized duration and the condition at the time of discharge. Conclusion ①Potential LVEF was compromised in the presence of heart disease. ②LVEF affect the postoperative pulmonary complication and fever,but not the times of bronchoscopical suction of sputum, hospitalized duration and the condition at the time of discharge.

关 键 词：胸部肿瘤 心功能 射血分数 

分 类 号：R730.5[医药卫生—肿瘤]