全胸腔镜肺叶切除对腹型肥胖低肺功能肺癌患者术后心肺功能的影响  

Effects of Complete Video-assisted Thoracoscopic Lobotomy on Heart and Lung Functions in Abdominal Obesity Patients with Lower Lung Function Lung Cancer

作　　者：张六伢[1] 李远静[1] 陈维[1] 孟小鹏[1] 

机构地区：[1]绍兴第二医院胸心外科,绍兴312000

出　　处：《中国微创外科杂志》2015年第10期917-921,共5页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的：探讨全胸腔镜肺叶切除对腹型肥胖低肺功能肺癌患者术后心肺功能的影响。方法2013年7月～2014年6月对23例腹型肥胖伴低肺功能肺癌行全胸腔镜肺叶切除术，观察术后1周内心肺并发症，术前2 d，术后第3、7天，1．5、3、6个月行肺功能检查及登楼试验，评价心肺功能。结果术后心肺并发症发生率39．1％（9／23）。术后第3天较术前FVC[（1．83±0．45）L vs．（2．70±0．68）L，q ＝7．936，P ＜0．05]、FEV 1．0[（1．05±0．29）L vs．（1．75±0．25）L，q ＝9．745，P ＜0．05]、FEV 1．0／FVC[（53．3±7．6）％ vs．（70．2±6．0）％，q ＝9．902，P ＜0．05]、MVV[（55．3±14．9）L ／min vs．（86．8±16．5） L ／min，q ＝9．279，P ＜0．05]、FRC[（1．50±0．27）L vs．（2．25±0．35）L，q ＝8．920，P ＜0．05]明显下降，术后第7天较术前FVC[（2．07±0．53）L vs．（2．70±0．68）L，q ＝5．747，P ＜0．05]、FEV 1．0[（1．35±0．31）L vs．（1．75±0．25）L，q ＝5．568，P ＜0．05]、FEV 1．0／FVC[（57．6±7．4）％ vs．（70．2±6．0）％，q ＝7．382，P ＜0．05]、MVV[（66．3±15．8）L ／min vs．（86．8±16．5） L ／min，q ＝6．038，P ＜0．05]、FRC[（1．68±0．35）L vs．（2．25±0．35）L，q ＝6．779，P ＜0．05]下降明显；术后第7天与第3天比较，FEV 1．0[（1．35±0．31）L vs．（1．05±0．29）L，q ＝4．176，P ＜0．05]、MVV [（66．3±15．8）L ／min vs．（55．3±14．9） L ／min，q ＝3．240，P ＜0．05]有统计学差异，在短期内恢复；术后1．5月较术后第3、7天 FVC、FEV 1．0／FVC、MVV 明显好转（P ＜0．05），与术后3、6个月无统计学差异（P ＞0．05），肺功能趋于稳定；FVC、FEV 1．0、FEV 1．0／FVC、MVV 术后6个月与术前比较无统计学差异（P ＞0．05），表明肺功能已恢复到术前水平。登楼试验显示术后第7天仅2例（8．7％）�Objective To observe effects of complete video-assisted thoracoscopic lobotomy on heart and lung functions in abdominal obesity patients with lower lung function lung cancer. Methods A total of 23 cases of abdominal obesity patients with lower lung function lung cancer underwent complete video-assisted thoracoscopic lobotomy from July 2013 to June 2014.The heart and lung complications after operation in one week were observed,and lung function and climbing stair tests were conducted on the 2nd, 3rd and 7th postoperative day,as well as at 1 .5,3,and 6 months after operation,respectively. Results After the operation the incidence of heart and lung complications was 39.1 % （9 /23 ）.On the 3rd postoperative day,the FVC [（1 .83 ±0.45 ）L vs. （2.70 ±0.68）L,q =7.936,P 〈0.05 ],FEV 1 .0 [（1 .05 ±0.29）L vs.（1 .75 ±0.25 ）L,q =9.745,P 〈0.05 ],FEV 1 .0 /FVC [（53.3 ±7.6）% vs.（70.2 ±6.0）%,q =9.902,P 〈0.05 ],MVV [（55.3 ±14.9 ）L /min vs.（86.8 ±16.5 ）L /min,q =9.279,P 〈0.05],and FRC [（1 .50 ±0.27）L vs.（2.25 ±0.35）L,q =8.920,P 〈0.05]obviously decreased as compared with preoperative levels.On the 7th postoperative day,the FVC [（2.07 ±0.53）L vs.（2.70 ±0.68）L,q =5.747,P 〈0.05],FEV 1 .0 [（1 .35 ±0.31 ）L vs.（1 .75 ±0.25）L,q =5.568,P 〈0.05],FEV 1 .0 /FVC [（57.6 ±7.4）% vs.（70.2 ±6.0）%,q =7.382, P 〈0.05],MVV [（66.3 ±15.8）L /min vs.（86.8 ±16.5 ）L /min,q =6.038,P 〈0.05 ],and FRC [（1 .68 ±0.35 ）L vs.（2.25 ±0.35 ） L,q =6.779,P 〈0.05 ] obviously decreased than those in preoperation.Comparison between 7th and 3rd postoperative day showed the FEV 1 .0 [（1 .35 ±0.31 ）L vs.（1 .05 ±0.29 ）L,q =4.176,P 〈0.05 ]and MVV [（66.3 ±15.8） L /min vs.（55.3 ±14.9）L /min,q =3.240,P 〈0.05]restored rapidly.At the 1 .5 postoperative months,the FVC,FEV 1 .0 /FVC, MVV were improved significantly than those on the 3rd and 7th postoperative day （P 〈0.05 ）and had no statistical differences as compared with 3 and 6 postop

关 键 词：腹型肥胖 肺癌 全胸腔镜 肺叶切除 低肺功能 

分 类 号：R734.2[医药卫生—肿瘤]