【摘要】 目的 :应用超声心动图研究老年肺癌患者肺切除术后早期右心血流动力学改变和氨力农对右心功能的作用。方法 :肺癌患者 5 0例 ,肺叶切除组 3 1例 ,全肺切除组 19例。用多谱勒超声测定术前、术后右心血流动力学指标 ,术后使用氨力农 7d观察。结果 :肺切除术后右心室射血分数 (RVEF)较术前降低 ,其中肺叶切除组P <0 0 5 ,t=2 0 88,全肺切除组P <0 0 1,t =4 14 1;右室舒张末容积指数 (RVEDVI)较术前增加 ,肺叶切除组P <0 0 5 ,t =2 65 1,全肺切除组P <0 0 5 ,t =2 73 5 ;平均肺动脉压 (mPAP)较术前增加 ,肺叶切除组P <0 0 1,t =3 70 1,全肺切除组P <0 0 1,t =4 912 ;肺动脉收缩压 (PAsP)较术前增加 ,肺叶切除组P <0 0 1,t =3 5 3 4,全肺切除组P <0 0 1,t=4 2 91;肺血管阻力指数 (PVRI)较术前增加 ,肺叶切除组P <0 0 5 ,t =2 72 3 ,全肺切除组P <0 0 1,t =3 10 4;右室收缩压 (RvsP)较术前增加 ,肺叶切除组P<0 0 5 ,t=2 5 87,全肺切除组P <0 0 5 ,t=2 778。使用氨力农可降低RVEDVI、mPAP、PAsP、PVRI和改善RVEF。结论 :肺切除术后早期右心功能减退 ,平均肺动脉压和肺血管阻力增高。氨力农能够改善右心功能 ,减少术后心脏并发症的发生更多还原

【Abstract】 OBJECTIVE: To determine the changes of right ventricular(RV) hemodynamics in the early phase after lung resection in elderly patients with lung cancer by Doppler echocardography and to investigate the role of amrinone on RV function.METHODS:Fifty patients with lung cancer underwent lobectomy (n=31) or pheumonectomy (n=19). RV hemodynamic indices were calculated by Doppler echocardiography before and after the operation. Amrinone was used in this study to evalute the effect on RV function on postoperative Day 7. RESULTS:Right ventricular ejection fraction (RVEF) significantly decreased and right ventricular end diastolic volume index (RVEDVI), mean pulmonary artery pressure (mPAP). Pulmonary artery systolic pressure (PAsP), and pulmonary vessel resistance index (PVRI) significunfly increased. In the group of major lung resection. The administration of amrinone was shown to reduce mPAP,PAsP,PVRI and RVEDVI,and to improve the RVEF. CONCLUSIONS:RV function declines, the mPAP and PVRI increases in early phase after lung resection. The use of amrinone can improve RV function and decrease carcliac complications.更多还原