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feng shi xing xin zang bing er jian ban xia zhai huan zhe ban mo zhi huan qian hou hu xi gong neng de bian hua
Author(s): 
Pages: 94-96
Year: Issue:  S1
Journal: Academic Journal of Second Military Medical University

Keyword:  风湿性心脏病瓣膜替换术麻醉肺功能血流动力学;
Abstract: 目的:测定瓣膜替换术中呼吸功能的变化,为瓣膜替换术中、术后的呼吸管理提供依据。方法:用旁气流呼吸功能监测的方法,以PAP3.3kPa为界,测定轻度和中度肺高压患者组(分别为L和H组)术中呼吸功能和血流动力学的变化,并行肺病理学检查。结果:两组各时点胸肺顺应性均处于正常低限;H组的分钟通气量及诱导后开胸前的气道压略高于L组,但各个时点及两组间均无显著性差异。CPB前两组CI明显低于正常。H组开胸前及开胸后PAP、PVR显著高于L组。CPB后关胸前值与开胸后CPB前值比较,H组CI增高、MAP、SVR下降及L组MAP、SVR下降有显著性差异。4例肺病理学检查均存在肺肌型动脉环形增生、内膜部分肌化。结论:轻~中度肺动脉高压虽然对肺组织结构产生一定的影响,但尚未构成对呼吸力学方面的严重损害。
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