天津医药

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左室舒张功能不全患者肺叶切除术后早期左心功能的变化

李新,张鹏   

  1. 天津医科大学总医院心胸外科
  • 收稿日期:2012-07-24 修回日期:2012-12-31 出版日期:2013-07-15 发布日期:2013-07-15
  • 通讯作者: 李新

Early changes of left ventricular function after lobectomy in patients with left ventricular diastolic dysfunction

li xin,ZHANGPENG   

  • Received:2012-07-24 Revised:2012-12-31 Published:2013-07-15 Online:2013-07-15
  • Contact: li xin

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摘要：

【摘要】 目的  探讨合并左室舒张功能不全患者肺切除术后早期左心收缩舒张功能的变化。方法  收集62例行肺叶切除术且合并左室舒张功能不全的患者,于术前1~3d、术后3d和8d行超声心动及组织多普勒检查,检测二尖瓣血流舒张早期峰值速度(E)、二尖瓣心房收缩期血流峰值速度(A),计算E/A值;二尖瓣环舒张早期峰值运动速度(Em)、二尖瓣环舒张晚期峰值运动速度(Am)、计算E/Em;左室射血分数(LVEF)、二尖瓣环收缩期峰值运动速度(Sm);并连续监测患者生命体征,对术前术后上述指标进行比较分析。结果  术后3d患者E、E/A及E/Em高于术前,Em、Sm低于术前;术后8dE/Em高于术前,Em低于术前(均P<0.05);LVEF、Em/Am术前术后差异无统计学意义(P>0.05)。结论  合并左室舒张功能不全的患者在肺切除术后早期左心收缩和舒张功能均出现下降,收缩功能较舒张功能较早恢复至术前水平;组织多普勒检查能够更敏感的检测心功能变化。 

关键词: 心室功能障碍, 左, 肺切除术, 心室功能, 左, 超声检查, 多普勒, 彩色

Abstract: Objective  To evaluate left ventricular diastolic dysfunction in patients with combined pulmonary resection of early left ventricular systolic and diastolic function changes. Methods   62 cases with left ventricular diastolic dysfunction in patients before surgery, 3 days after 8 days, respectively, and tissue Doppler ultrasound heart examination, testing reflect diastolic function the peak early diastolic mitral flow velocity (E), mitral peak atrial systolic blood flow velocity (A), E / A , peak early diastolic mitral annulus velocity (Em) peak late diastolic mitral annular velocity (Am), calculation of E / Em; reflect the contractile function of left ventricular ejection fraction (LVEF), mitral annular peak systolic velocity Sm. Continuous monitoring of patient vital signs after surgery. Results   Compared with the previous 3 days after surgery in patients with heart rate, E faster (P <0.05), E / A increased (P <0.05), Em was significantly lower (P <0.01), E / Em significant rise higher (P <0.01), Sm lower (P <0.05), LVEF change was not statistically significant (P> 0.05); and after eight days before surgery compared to patients with heart rate, E, E / A, LVEF and Sm changes are not statistically significant (P> 0.05), Em decreased (P <0.05), E / Em increased (P <0.05). Conclusion   The combined left ventricular diastolic dysfunction in patients early after lung resection, left ventricular systolic and diastolic functions are declining, systolic function earlier than the diastolic function returned to preoperative levels; tissue Doppler examination can be more sensitive detection changes in cardiac function.

Key words: Ultrasonography, Doppler, color, Echocardiography, 彩色