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目的 探讨肺癌患者肺切除术后多普勒肺血流频谱的动态变化及多普勒肺血流频谱对肺癌肺切除危险性的评估。方法 分别测定 49例肺癌患者全肺 ( 12例 )及肺叶 ( 3 7例 )切除术前、术后 3～ 5天、术后8～ 10天的多普勒肺血流频谱 ,并按手术方式及术后有无心律失常进行分组。结果 肺切除术后 3～ 5天所有患者肺血流频谱均发生改变 ,表现为右室射血前期 (PEP)延长 ,右室射血加速时间 (ACT)缩短 ,PEP/ACT升高 ,肺动脉平均压 (PAMP)及肺血管阻力 (PVR)均升高 ,这些数据与术前相比有显著性差异 (P <0 .0 1)。肺叶切除患者在术后 8～ 10天上述指标恢复至术前水平 ,而全肺切除组在术后 8～ 10天上述指标的改变仍持续存在。肺切除术后有心律失常组与无有心律失组术前的肺血流频谱有明显差异 (P <0 .0 1)。结论 肺癌患者肺切除术后肺循环血液动力学明显改变 ,全肺切除术改变持续时间更久。肺切除术后心律失常患者术前肺循环血液动力学的指标已有明显改变。多普勒肺血流频谱既能有效地观察肺切除术后肺循环血液动力学指标的变化 ,又能在术前对手术危险性进行一定的评估
Objective To investigate the dynamic changes of Doppler pulmonary blood flow spectrum after lung resection in patients with lung cancer and the assessment of the risk of lung cancer lung cancer by Doppler pulmonary blood flow spectrum. Methods The Doppler pulmonary blood flow spectrum of 49 patients with lung cancer (12 cases) and lobes (37 cases) before and after operation, 3 to 5 days after operation and 8 to 10 days after operation were measured respectively. And whether there is arrhythmia after surgery grouping. Results All patients underwent pulmonary resection 3 to 5 days after pulmonary blood flow spectrum were changed, the performance of the right ventricular ejection period (PEP) prolonged right ventricular ejection time (ACT) shortening, PEP / ACT increased pulmonary artery mean Both PAMP and PVR increased, which were significantly different from those before operation (P <0.01). In the patients with lobectomy, the above indexes returned to their preoperative levels from 8 to 10 days after operation, while those in the pneumonectomy group remained unchanged after 8 to 10 days. There was a significant difference in the pulmonary blood flow spectrum between the patients with and without arrhythmia after pneumonectomy (P <0.01). Conclusion The hemodynamics of pulmonary circulation in patients with lung cancer after pneumonectomy was significantly changed, and pneumonectomy changed longer. Preoperative pulmonary circulation hemodynamic parameters of patients with arrhythmia after pneumonectomy have been significantly changed. Doppler pulmonary blood flow spectrum can not only effectively observe the change of hemodynamic parameters of pulmonary circulation after lung resection, but also preoperatively assess the risk of surgery