肺切除後残存肺の膨張判定の一指標
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概要
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Some simple method of test for pulmonary function, to be employed in determining the degree of re-expansion of the residual portion of the lung in the follow-up stydy of patients following lung resection, has been sought after. The author assumed that the use of the ratio % MBC/% VC as an index might be of value for this purpose. It might also be of value in determining whether the residual portion is properly re-expanded and whether there is over-expansion which may cause chronic emphysematous change to occur in the future. So, in an attempt to evaluate this method, the degree of re-expansion of the residual portion was examined and pulmonary function tested in 63 patients who had had the lungs resected up to five segments without an additional thoracoplasty, with no postoperative complications. Roentgenographically, they were divided into two groups : those with a dead space and those without one. (Gaensler et al. had referred to this ratio as air velocity index. Here the ratio is used for an entirely different purpose.) 1. In determining the ratio, the values less than 1.0 were found in many patients with no dead space (in 20 out of 29 patients), while values more than 1.0 were found in many patients with a dead space (in 28 out of 34 patients). It would seem that the index is a useful guide to re-expansion of the residual portion of the lung. 2. Pulmonary function tests were carried out 6 months after operation in 5 patients who had undergone an extensive lung resection, with the residual portion so well re-expanded as to leave no dead space. (4 patients had had left upper lobectomy, and 1 right upper lobectomy with the resection of one segment.) The ratio RV/TLC was slightly increased aboue normal, but blood gas content was normal. No patients showed emphysematous change due to over-expansion. The index was in the range 1.0 to 0.8. 3. pulmonary function was tested 24 months after operation in 3 patients who had undergone extensive lung resection, with the residual portion as well re-expanded as the 5 patients reviewed above. (2 patients had had left upper lobectomy, and 1 right upper lobectomy with the resection of one segment.) The ratio RV/TLC was slightly increased above normal, but blood gas content was in the normal range. All the patients were free from emphysematous change due to ove-erxpansion of the residual portion. The index ranged from 1.0 to 0.8. In view of the observations made in this experiment, it may be said that the ratio %MBC/% VC is of value as an index in the determination of the degree of re-expansion of the residual portion of the lung following pulmonary resection. The patients with no dead space will be free from the failure of pulmonary function and will not need an additional thoracoplasty, if the index is in the range 1.0 to 0.8.
- 千葉大学の論文
- 1960-11-28
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- 肺切除後残存肺の膨張判定の一指標