正中开胸和胸腔镜手术对二尖瓣反流患者术后心肺功能影响的对比
Comparison of Effects of Median Thoracotomy and Thoracoscopic Surgery on Postoperative Cardiopulmonary Function in Patients with Mitral Regurgitation
张生清 1林招芹 1马欢1
作者信息
- 1. 广东省心血管病研究所心脏康复科 南方医科大学附属广东省人民医院(广东省医学科学院),广州 510080
- 折叠
摘要
目的 比较正中开胸手术和胸腔镜手术对二尖瓣反流患者术后心肺功能变化的影响.方法 选取了2018年9月至2019年3月在广东省人民医院进行二尖瓣成形术的35例二尖瓣反流患者,根据手术方式分为胸腔镜组(n=15)和正中开胸组(n=20),并在手术前后进行肺通气功能检查和心肺运动试验.结果 35例二尖瓣反流患者进行二尖瓣成形术后,其肺通气功能指标[包括用力肺活量(forced vital capacity,FVC)、FVC占预计值的百分比(FVC%pred)、第1秒用力呼气容积(forced expiratory volume in 1 second,FEV1)、第1秒用力呼气容积占预计值的百分比(FEV1%pred)]出现不同程度的降低,而运动心肺功能指标[峰值摄氧量(peak oxygen uptake,Peak VO2)、千克体质量摄氧量(Peak VO2/kg)、Peak VO2 占预计值的百分比(Peak VO2%pred)及VO2/kg@无氧阈(anaerobic threshold,AT)]较术前有不同程度的提高.不同手术方式患者手术前后的肺通气功能指标和运动心肺功能指标比较,差异无统计学意义(P>0.05).结论 正中开胸手术和胸腔镜手术两种术式均可改善二尖瓣反流患者术后的心肺功能,且二者之间未见明显差异.
Abstract
Objectives To explore and compare the effects of median thoracotomy and thoracoscopic surgery on the post-operative changes in cardiopulmonary function in patients with mitral regurgitation.Methods Totally 35 patients with mitral regurgitation who underwent mitral valve plasty at Guangdong Provincial People's Hospital from September 2018 to March 2019 were selected and divided into a thoracoscopic group(n=15)and a median thoracotomy group(n=20).Cardiopulmonary exercise test(CPET)and pulmonary ventilation function test were performed before and after the surgery,respectively.Results After undergoing mitral valve plasty in 35 patients with mitral regurgitation,pulmonary ventilation function indicators[including forced vital capacity(FVC),FVC%pred,forced expiratory volume in 1 second(FEV1),and FEV1%pred]decreased to varying degrees compared to before surgery,while cardiopulmonary function indicators[Peak VO2/kg,Peak VO2 pred,and VO2/kg@anaerobic threshold(AT)]had varying degrees of improvement compared to before the surgery.There were no significant differences in lung ventilation function indicators and cardiopul-monary function indicators between patients with different surgical methods before and after surgery.Conclusions Both types of mitral valve plasty can improve postoperative cardiopulmonary function in patients,and there is no significant difference between the two methods.
关键词
正中开胸/胸腔镜手术/心肺功能/心肺运动试验Key words
median thoracotomy/thoracoscopic surgery/cardiopulmonary function/cardiopulmonary exercise test引用本文复制引用
出版年
2024
NETL
NSTL
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