COPD开胸手术后肺功能的改变与康复治疗  

Change and recovered treatments of lung function after thoracotomy on COPD

作　　者：杨鲁民[1] 邢秀民[1] 陈岩[1] 王伦青[1] 申瑞娟[1] 孙桂枝[1] 

机构地区：[1]青岛市人民医院胸心外科与呼吸内科,266001

出　　处：《临床肺科杂志》2004年第3期233-235,共3页Journal of Clinical Pulmonary Medicine

摘　　要：目的　探讨慢性阻塞性肺疾病 (COPD)患者开胸手术后肺功能的变化及相应处理方法。方法　 2 9例中 -重度 COPD开胸手术后患者在常规治疗的基础上 ,给予辅助排痰、呼吸及呼吸肌训练、心理支持等 ,其中 17例曾给予机械辅助通气。术后进行心电图、血压、呼吸频率及波形、血氧饱和度 (Sp O2 )及动脉血气分析等监测 ,半月后定期或酌情行肺功能复查。结果　术后 15天肺功能显示 MVV、FEV1 .0 、FVC、Pa O2 、Sp O2 均较术前明显下降 (P<0 .0 1) ,康复治疗至三个月时各项值恢复到术前水平 (P>0 .0 5 ) ,6个月后可优于术前水平 (P<0 .0 5 )。结论　中 -重度 COPD患者开胸术后早期 (<30天 )肺功能将显然下降 ,认真做好术后各项监测、综合治疗与评估 ,保障呼吸道通畅 ,有利于提高手术的安全性 。Objective To inquire into the chang and treatments of lung function after thoracotomy on chronic obstructive pulmonary disease(COPD).Methods 29 patients with moderate-severe COPD in our hospital accepted to eliminate sputum,breath train,respiratory muscle train,psychic healing,et al after thoracic surgery.Among them,17 cases were cured with mechanical ventilation.All patients accepted the monitor with EKG,blood pressure,respiratory rate and wave,SpO 2,arterial blood gas analysis et al after surgery.The lung function test was performed according to patients conditions and schedule after hald a month. Results The postoperative lung function at 15th day showed that MVV、FEV 1.0 、FVC、PaO 2、SpO 2 decreased significantly (P<0.01) compared to preoperation.However,3 months later,all indexes could return to the preoperative level(P>0.05), and were better than preoperation (P<0.05) after 6 months.Conclusion The lung function of patients with moderate-severe COPD will decrease significantly in early stage after thoracic surgery(<30 days) .To Handle strictly in the monitors,composite treatments and assessments for keep unobstructed respirtaory tract in postoperative period will be of value to surgical safety and improvement of patients' lung function.

关 键 词：慢性阻塞性肺疾病 开胸手术 肺功能 康复治疗 COPD 

分 类 号：R655[医药卫生—外科学]