摘要目的:应用超声斑点追踪成像(STE)技术评价不同范围肺切除术后患者1年期右室收缩功能的变化规律。方法:抽取2016年1月至2019年12月于郑州大学附属洛阳中心医院住院进行肺切除手术治疗的患者共67例，其中单侧全肺切除(P组)17例，肺叶切除(L组)50例。分别在患者行肺切除术前(T1)、术后1周(T2)、术后1个月(T3)、术后3个月(T4)、术后6个月(T5)、术后1年(T6)，获取其常规超声心动图参数及右室壁各节段和整体纵向应变值，比较不同时间以及相同时间两组患者间上述参数之间的差异。结果:两组患者T2时右室游离壁各节段收缩期纵向峰值应变(LS)和右室游离壁纵向峰值应变(RVFWLS)、右室整体纵向峰值应变(RVGLS)均较T1时减低( P均<0.05)；L组上述参数T3时较T1时减低，T5、T6时较T3时增高( P<0.05)；P组上述参数T3时较T2时减低( P<0.05)，T4、T5、T6时与T3时比较差异未见统计学意义( P>0.05)。两组患者T2时室间隔右室侧各节段LS较T1时减低( P<0.05)，T3时较T2时增加( P<0.05)，T3、T4、T5、T6分别与T1时比较差异未见统计学意义( P>0.05)。P组T2、T3、T4、T5、T6时右室游离壁各节段LS和RVFWLS、RVGLS均小于L组同期水平( P<0.05)。 结论:肺切除术后1周患者可出现右室局部和整体收缩功能受损。单侧全肺切除术对患者右室收缩功能影响较肺叶切除术大且持续时间长。

abstractsObjective:To evaluate the right ventricles systolic function by speckle tracking echocardiography in patients one year after different ranges of pneumonectomy.Methods:A total of 67 patients underwent pneumonectomy in Luoyang Central Hospital Affiliated to Zhengzhou University from January 2016 to December 2019 were selected. There were 17 cases of unilateral pneumonectomy (group P) and 50 cases of lobectomy (group L). Before operation (T1), 1 week after operation (T2), 1 month after operation (T3), 2 months after operation (T4), 6 months after operation(T5), and 1 year after operation(T6), the parameters of echocardiography and the longitudinal systole peak strain (LS) of six segments and right ventricle global longitudinal strain (RVGLS) were obtained. Within-group comparison of the above parameters at different time, and cross-group comparison on the above parameters at the same time were performed.Results:For the patients in the two groups, the LS of right ventricular free wall, right ventricle free wall longitudinal strain (RVFWLS) and RVGLS at T2 were lower than those at T1 ( P<0.05). In group L, the above parameters at T3 were lower than those at T1, and parameters at T5 and T6 were higher than those at T3 ( P<0.05). In group P, the above parameters at T3 were lower than those at T2 ( P<0.05); but LS of right ventricular free wall and RVFWLS, RVGLS at T4, T5, and T6 had no significant difference with those at T3 ( P>0.05). In the two groups, the LS of basal segment, middle segment and apical segment of ventricular septum at T2 were lower than those at T1 ( P<0.05); and they increased at T3 compared with those at T2 ( P<0.05); but the parameters at T3, T4, T5, T6 had no significant difference with those at T1 ( P>0.05). There was no statistically significant difference in synchronic comparison on LS of any segment of ventricular septum, RVFWLS or RVGLS between group P and group L at T3, T4, T5, T6 ( P<0.05). Conclusions:Local and global systolic function of right ventricles may be impaired 1 week after pneumonectomy. Pneumonectomy had a greater effect on ventricular systolic function than lobectomy, and the duration is longer.