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[目的]研究非小细胞肺癌(NSCLC)胸腔镜肺段切除术后肺功能的损伤情况。[方法]对68例ⅠA期NSCLC患者,行2次以上肺功能检查,分别于术前与术后第3d和或术后3个月测试肺功能。术后第3d天测试肺功能的44例患者为A组,术后3个月测试肺功能的24例患者为B组。[结果 ]两组术前肺功能没有差异。A组术后第3d肺功能水平:用力肺活量(forced vital capacity,FVC)为(1.46±0.56)L,FVC%为41.58%±10.56%,1秒用力呼气容积(forced expiratory volume in one second,FEV1)为(1.31±0.50)L,FEV1%为46.35%±12.09%,FEV1/FVC(%)为89.78%±5.71%,最大呼气流速峰值(peak expiratory flow,PEF)为(2.94±1.42)L/s,每分钟最大通气量(maximal voluntary ventilation,MVV)为(49.29±4.23)L/min,肺一氧化碳弥散因子(transfer factor for carbon monoxide of lung,TLCO)为(4.04±1.08)mmol/min/k Pa,TLCO%为48.40%±11.12%,比术前降低明显(P<0.05)。B组术后3个月肺功能水平:FVC为(2.88±1.02)L,FVC%为81.19%±14.46%,FEV1为(2.36±0.84)L,FEV1%为82.74%±15.09%,FEV1/FVC(%)为82.23%±10.13%,PEF为(5.17±1.89)L/s,MVV为(83.00±29.58)L/min,TLCO为(7.10±1.58)mmol/min/k Pa,TLCO%为77.00%±24.24%,相比A组第3d肺功能水平有所提高。[结论]肺癌胸腔镜肺段切除在术后极早期(术后3d)与术前相比,肺功能损伤较大。术后3个月时,患者的肺功能很可能可以达到正常水平,但与术前相比还有一定的差距。
[Objective] To study the damage of lung function after thoracoscopic segmentectomy for non-small cell lung cancer (NSCLC). [Method] Sixty-eight patients with stage ⅠA NSCLC underwent pulmonary function tests for more than two times. The pulmonary function tests were performed before and after operation for 3 days and 3 months or 3 months respectively. Forty-four patients tested for lung function on day 3 postoperatively were in group A, and 24 patients tested for lung function at 3 months post-operation were in group B. [Results] There was no difference in preoperative lung function between the two groups. The level of pulmonary function at the third day after operation in group A was (1.46 ± 0.56) L in forced vital capacity (FVC), 41.58% ± 10.56% in FVC%, forced expiratory volume in one second (1.31 ± 0.50) L for FEV1, 46.35% ± 12.09% for FEV1, 89.78% ± 5.71% for FEV1 / FVC and 2.94 ± 1.42 for peak expiratory flow (PEF) (49.29 ± 4.23) L / min, and the TLCO of L / s, MVV was 4.04 ± 1.08 mmol / min / k Pa, TLCO% was 48.40% ± 11.12%, significantly lower than preoperative (P <0.05). The level of pulmonary function in group B at 3 months after operation was (2.88 ± 1.02) L for FVC, 81.19% ± 14.46% for FVC, (2.36 ± 0.84) L for FEV1, 82.74% ± 15.09% for FEV1, FEV1 / FVC (P <0.001), PVE was (5.17 ± 1.89) L / s, MVV was (83.00 ± 29.58) L / min, TLCO was (7.10 ± 1.58) mmol / min / kPa and TLCO% was 77.00 % ± 24.24%, compared with the 3rd group A group lung function level increased. [Conclusion] Pulmonary thoracoscopic resection of lung segment in the early postoperative period (3d) compared with preoperative lung function damage. 3 months after surgery, the patient’s lung function is likely to reach the normal level, but compared with preoperative there is a certain gap.