本文選題：縱隔疾病 + 運動心肺功能��； 參考：《中國全科醫(yī)學》2017年36期

【摘要】：目的探討縱隔疾病患者運動心肺功能的特點及其可能的影響因素。方法回顧性選取2014年11月—2016年11月于首都醫(yī)科大學附屬北京胸科醫(yī)院住院的符合納入標準的縱隔疾病患者44例為病例組,選取同期于本院住院的靜息心電圖、靜息肺功能正常及心電圖運動試驗陰性的非縱隔疾病患者32例為對照組。按病變周圍有無血管受侵,將病例組分為有血管受侵亞組(34例)和無血管受侵亞組(10例)。根據(jù)病變部位,將病例組分為前縱隔亞組(34例)和中、后縱隔亞組(10例)。記錄患者靜息心電圖檢查、靜息肺功能檢查、心肺運動試驗(CPET)相應觀察指標。結果所有患者靜息心電圖呈竇性心律,無缺血性ST-T段改變。病例組肺活量占預計值百分比(VC%)低于對照組,殘氣量/肺總量(RV/TLC)、總氣道阻力占預計值百分比(R_5%)高于對照組(P0.05)。病例組運動負荷占預計值百分比(W%)、最大攝氧量占預計值百分比(VO_2%)、氧脈搏占預計值百分比(VO_2/HR%)、呼氣潮氣容積(VTex)、潮氣容積/肺活量(VT/VC)、血氧飽和度(SpO_2)低于對照組,呼吸頻率(BF)高于對照組(P0.05)。中、后縱隔亞組W%、呼吸儲備(BR)高于前縱隔亞組,呼吸困難指數(shù)(DI)低于前縱隔亞組(P0.05)。有血管受侵亞組W%低于無血管受侵亞組(P0.05)。結論縱隔疾病患者運動耐力、運動心功能、運動肺功能均下降。患者的靜息肺功能、縱隔病變部位及血管受侵可能對其運動心肺功能有一定影響。
[Abstract]:Objective to investigate the characteristics of cardiopulmonary function in patients with mediastinal diseases and its possible influencing factors. Methods 44 patients with mediastinal diseases who were hospitalized in Beijing chest Hospital affiliated to Capital Medical University from November 2014 to November 2016 were retrospectively selected as the case group. 32 patients with normal resting lung function and negative electrocardiogram exercise test were the control group. According to the presence of vascular invasion around the lesion, the patients were divided into two groups: 34 patients with vascular invasion and 10 patients with no vascular invasion. According to the lesion location, the patients were divided into anterior mediastinal subgroup (34 cases) and middle mediastinal subgroup (10 cases) and posterior mediastinal subgroup (10 cases). The resting electrocardiogram (ECG), resting pulmonary function and cardiopulmonary exercise test (CPETs) were recorded. Results all patients showed sinus rhythm and no ischemic ST-T segment changes. The percentage of vital capacity to predicted value in the case group was lower than that of the control group, and the residual volume / total lung volume was higher than that of the control group, and the percentage of total airway resistance to the predicted value was R5) higher than that of the control group (P 0.05). In the case group, the percentage of exercise load to the predicted value, the percentage of maximal oxygen uptake to the predicted value, the percentage of oxygen pulse to the predicted value, the percentage of oxygen pulse to the predicted value, the volume of expiratory tidal volume and VTextam, the volume of tidal volume / vital capacity, VT / VCU, and the oxygen saturation of SPO _ 2 were lower than those of the control group. The respiratory frequency (BF) was higher than that in the control group (P 0.05). In the middle, posterior mediastinal subgroup, the BRR of the respiratory reserve was higher than that of the anterior mediastinal subgroup, and the dyspnea index (DII) was lower than that of the anterior mediastinal subgroup (P0.05). W% in the subgroup with vascular invasion was lower than that in the subgroup without vascular invasion (P 0.05). Conclusion exercise endurance, exercise heart function and exercise lung function in patients with mediastinal diseases are all decreased. The resting pulmonary function, mediastinal lesion site and vascular invasion may have some effects on the exercise cardiopulmonary function.
【作者單位】： 首都醫(yī)科大學附屬北京胸科醫(yī)院心肺功能室;
【分類號】：R564

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