右心室射血分数评价肺切除术的危险性  

Right ventricular ejection fraction by echocardiography in the preoperative risk evoluation for pulmonary resection.

作　　者：李韬[1] 王茂生[1] 黄健[1] 刘庆春[2] 吴全忠[1] 

机构地区：[1]茂名市人民医院胸心外科,广东省525000 [2]茂名市人民医院,广东省525000

出　　处：《中华胸心血管外科杂志》1999年第6期350-352,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的：探讨术前右心室射血分数（ＲＶＥＦ） 与肺切除术后并发症的关系以及肺切除术对ＲＶＥＦ 的影响。方法：应用超声心动图连续对１２７ 例接受肺切除术的病人行术前ＲＶＥＦ测定，并对其中６１ 例于术后３ 周再测定ＲＶＥＦ。结果：有并发症组的术前ＲＶＥＦ较无并发症组显著降低（ Ｐ＜ ０ ．００１） 。按术前ＲＶＥＦ 值（ ≤３５ ％ 、＜ ４０ ％ 、＜ ４５ ％ 、≥４５ ％ ） 分组，各组并发症发生率差异有显著性（ Ｐ＜ ０ ．００５） ，并发症的发生率随ＲＶＥＦ的降低而升高，尤以ＲＶＥＦ＞ ４０ ％ 明显（ Ｐ＜ ０ ．００１） 。６１ 例病人术后ＲＶＥＦ 较术前显著减少（ Ｐ＜０ ．０１） 。结论：肺切除术可使右心功能减退，术前ＲＶＥＦ应列为肺切除术危险性的评价指标，术前超声测定ＲＶＥＦ＞ ４０ ％ 为肺切除术安全范围。Aim:This study evaluates the preoperative right ventricular ejection fraction(RVEF) as a predictor of postoperative complications after lung resection.Clinical material and method:RVEF was consecutively assessed in 127 patients before pulmonary resection by echocardiography.According to right ventricular function,the patients were divided into group Ia(n=41,RVEF≥45%),group Ib(n=46,RVEF<45%),and group Ic(n=21,RVEF<40%),group Id(n=19,RVEF<35%)。Postoperative cardiopulmonary complications occurred in two patients(4.9%) in group Ia,6(13%) in group Ib,13(61.9%) in group Ic,and 17(89.5%) in group Id.In addition patients were divided into two groups:group IIa(n=38) with postoperative complications and group IIb(n=89) without complications.Preopertive RVEF was 36.5%±4.61% in group IIa and 43.9%±3.32% in group IIb.Result:In group Ia,Ib,Ic,and Id,there were significant differences postoperative morbidities(P<0.005).Patients with a preoperative RVEF of less than 40% had a higher incidence of complications.In groups IIa and IIb,there was a significant difference between preoperative RVEF(P<0.01).Conclusion:We suggest that the preoperative RVEF could be a predictor of postoperative complications for lung resection.RVEF greater than 40% is considered as safe range for lung resection.

关 键 词：超声心动图 右心室射血分数 肺切除术 

分 类 号：R655.3[医药卫生—外科学]