右心室射血分数用于肺切除术危险性评价的临床研究  

Value of right ventricular ejection fraction in the preoperative risk evaluation for pulmonary resection

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

机构地区：[1]广东省茂名市人民医院胸心外科,525000 [2]广东省茂名市人民医院超声诊断科,525000

出　　处：《中国肺癌杂志》2002年第2期131-132,共2页Chinese Journal of Lung Cancer

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 2 5 4例接受肺切除术的患者行术前RVEF测定 ,并对其中 12 2例于术后 3周再测定RVEF。结果　有并发症组术前RVEF较无并发症组显著降低 (P <0 .0 0 1)。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 .0 0 5 ) ,并发症的发生率随RVEF的降低而升高 ,尤以RVEF <40 %明显 (P <0 .0 0 5 )。 12 2例患者术后RVEF较术前显著减少 (P <0 .0 1)。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之一。术前超声心动图测定RVEF >40 %为肺切除术安全范围。Objective To evaluate the preoperative right ventricular ejection fraction (RVEF) as a predictor of postoperative complications after lung resection. Methods RVEF was consecutively assessed in 254 patients before pulmonary resection by echocardiography. According to preoperative right ventricular function, the patients were divided into: group Ia (n=82, RVEF≥45%), group Ib (n=92,RVEF<45%), group Ic (n=42, RVEF<40%),and group Id (n=38, RVEF≤35%). Postoperative RVEF was detected again in 122 patients 3 weeks later after lung resection. Results Preoperative RVEF of patients with postoperative complications was significantly higher than that of patitents without postoperative complications (P<0.001). Among group Ia, Ib, Ic, and Id, there were significant differences in postoperative morbidities (P<0.005). Patients with a preoperative RVEF less than 40% had a higher incidence of complications than those with RVEF over 40% (P<0.005). Of the 122 patients, postoperative RVEF was remarkably lower than preoperative RVEF (P<0.01). Conclusion The preoperative RVEF may be a predictor of postoperative complications for lung resection. RVEF higher than 40% is considered as a safe range for pneumonectomy.

关 键 词：超声心动图 右心室射血分数 肺切除术 危险性评价 术后并发症 

分 类 号：R655.3[医药卫生—外科学]