胸腔镜下与开胸肺叶切除术后心肌做功指数评价右心功能的对比研究  

Comparison of right ventricular function with thoractomy and video-assisted thoracic surgery lobectomy by Tei index

作　　者：高雷[1] 吴勤[1] 徐新华[1] 谭思创[2] 金万存[1] 杨一峰[2] 

机构地区：[1]心研所心脏超声专科,中南大学湘雅二医院,湖南长沙410011 [2]心研所心胸外科,中南大学湘雅二医院,湖南长沙410011

出　　处：《中国内镜杂志》2015年第2期199-202,共4页China Journal of Endoscopy

摘　　要：目的应用组织多普勒心肌做功指数(Tei指数)对比评价胸腔镜和传统开胸肺叶切除术两种手术方法对右心功能的影响。方法将60例行肺叶切除术患者分为胸腔镜组和开胸组各30例。应用右心组织多普勒分别检测两组术前、术后7 d、1个月、3个月和6个月的Tei指数。结果两组术前Tei指数比较差异无显著性;术后7 d时,胸腔镜组与开胸组Tei指数较术前均显著增高,且开胸组增高更为明显;术后1个月时,胸腔镜组恢复到术前水平,而开胸组仍较术前显著增高,且同期比较,胸腔镜组亦显著低于开胸组;术后3个月及6个月时,两组Tei指数均恢复到术前水平,且两组之间同期比较差异无显著性。结论与传统开胸手术相比,胸腔镜下肺叶切除术后对右心功能影响较小且恢复较快。【Objective】To evaluate the changes of the right ventricular function after thoractomy and videoassisted thoracic surgery（VATS） lobectomy by Tei index derived from tissue Doppler imaging.【Methods】The right ventricular function was measured by Tei index for thirty patients with VATS lobectomy and another 30 patients with thoractomy lobectomy in preoperative and postoperative 7 days, 1 month, 3 months and 6 months with tissue Doppler imaging. 【Results】No significant difference of Tei index between two groups before surgery; 7 days after surgery was found, Tei index of two groups were significantly increased, especially in thoractomy group; 1 month after surgery, Tei index of VATS group recovered to preoperative level but still increased in thoractomy group; 3 months and 6 months after surgery, Tei index of the two groups had no significant difference compared with preoperative level. 【Conclusion】Compared with thoractomy surgery, VATS lobectomy has less influence on right ventricular function and recover faster. Tei index of right ventricle derived from tissue Doppler imaging can estimate right ventricular function effectively after thoractomy and VATS lobectomy.

关 键 词：胸腔镜 肺叶切除 右心功能 心肌做功指数 组织多普勒 

分 类 号：R322.35[医药卫生—人体解剖和组织胚胎学]