目的:1.比較肺部手術前後肺功能、呼吸肌肌力和運動耐力的差異;2.比較不同程度肺部切除手術後實際測量和依術前肺功能和切除大小校正後兩種肺功能值的差異;3.探討影響住院日數和術後肺功能、呼吸肌力和運動耐力的不足的因素。方法:受試者為39名在臺大醫院接受肺部手術後無重大併發症的病患,在術前和在術後13.2±6.3天各接受一次肺功能和呼吸肌力的測量,其中26名患者還接受了3分鐘運動耐力的測試。結果:受試者在術後有30-40%明顯肺容積的下降、約50%氣流流速、4-7%呼吸肌肌力和26%運動耐力的下降。在小於肺葉切除、肺葉切除與大於肺葉切除三組病患間,只有胸管引流時間和最大呼氣流速的不足有明顯差異。病患住院日數與胸管引流時間、最大呼氣流速的不足成正相關(相關係數分別為0.87和 0.38 ),最大呼氣流速的不足和胸管引流時間也成正相關(相關係數=0.32 ),然而術後呼吸肌力和3分鐘運動耐力的差異和病人一般資料並無任何相關。結論:即使以切除肺部的程度做校正,病人在出院前的肺功能仍有明顯下降。此外,病患之呼吸肌肌力和三分鐘行走距離在術後也較術前有明顯下降。
Purposes: The purposes of the study were to 1) compare the pulmonary function, respiratory muscle strength, and exercise endurance before and after fling resection; 2) compare the percentage of impairment in pulmonary function, respiratory muscle strength, and exercise endurance for patients with different extent of resection; and 3) investigate the determinants of hospital stay and the impairment in pulmonary function, respiratory muscle strength, and endurance. Methods: Thirty-nine consecutive patients who had lung resection without major complications at the National Taiwan University Hospital served as the subjects of the study. Each of the subjects took a complete pulmonary function test (PFT) that includes measurements of VC, MVV, FVC, FEV1, FEV1/ FVC, PEF, maximal inspiratory and expiratory mouth pressure (M I P and M EP) before surgery and before discharge (13.2±6.3 days after operation)﹒ In addition, 26 of them took walking tests for 3 minutes before and after surgery, respectively, Results: The results of the study demonstrated that the patients had significant reductions in lung volume, flow, respiratory muscle strength, and distance walked after thoracic surgery by the averages of 30-40%, 50%, 4-7%, and 26 %, respectively. Patients who underwent more than lobectomy had longer duration of chest tube drainage than patients who underwent less than lobectomy. However, patients who underwent less than lobectomy had higher percentage of impairment in PEF than the other patients. Significant correlations included the relationship of hospital stay with duration of chest tube drainage and impairment of PEF (r= 0.87 and 0.38, respectively), impairment of PEF with duration of chest tube drainage (1'=0.32), while none of the changes in MIP, MEP, or walking distαnee were correlated. with other variables. Conclusion: After lung resection, patients still have significant impairments in PFT after using the extent of resection as the correction factor. Their MlP, MEP, and walking ability were also reduced. The length of hospital stay highly correlated with the duration of chest tube drainage.