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Akciğer Rezeksiyonunun Kardiyak Fonksiyonlara Etkisinin Ekokardiyografik Olarak Araştırılması

Ecocardiographical Investigation for Effects of Pulmunary Resection on Cardiac Function

Journal Name:

  • Fırat Tıp Dergisi

Publication Year:

  • 2011

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Objective: This study was designed to evaluate the effect of the major pulmonary resections including lobectomy and pneumonectomy on the heart using an echocardiography. Materials and Methods: Sixteen patients who was hospitalized in the clinic of Thoracic Surgery, underwent a major pulmonary resection were included into the study. These patients were grouped into two according to the surgical procedure (lobectomy or pneumonectomy). For each patients, the blood gas analysis, the respiratory function test, and an echocardiography were performed just before the operation (preoperative) and sixth month after the operation (postoperative). Results: Compared with the preoperative values, the postoperative values for both FEV1 and FVC were significantly lower in both groups (p<0.05). There were no differences in the pO2 and pCO2 level, either pre- or postoperatively, in both groups (p>0.05). In the lobectomy group, the surgery caused no significant changes in both left and right heart functions and pressures in the postoperative period (p>0.05). The same result was obtained in the left heart measurements following the pneumonectomy (p>0.05), but six months after the surgery, the pulmonary arterial pressure (preoperative 27.80±11.10, postoperative 33.20±8.10, p=0.011), the diameter of the right ventricle (preoperative 22.40±0.78, postoperative 24.50±1.81, p=0.011), and the velocity of the tricuspid valve (preoperative 2.08±0.57, postoperative 2.37±0.42, p=0.010) were significantly increased. Conclusion: Compared with cardiac catheterisation and radionuclide ventriculography, echocardiography is a more efficient, cheap, and non-invasive method in the evaluation of the cardiac functions. A thoracic surgeon should avoid a pneumonectomy as much as possible, since the procedure causes more changes in the right ventricle modifications
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Abstract (Original Language): 
Amaç: Lobektomi ve pnömonektomi gibi majör akciğer rezeksiyonlarının kalp üzerine yarattığı etkiler ekokardiyografi kullanılarak gösterilmeye çalışılmıştır. Gereç ve Yöntemler: Göğüs Cerrahisi kliniğimizde çeşitli nedenlerle akciğer rezeksiyonu uygulanan 16 olgu çalışmaya alındı. Hastalar lobektomi ve pnömonektomi adlı 2 gruba ayrıldı. Her hastanın preoperatif dönemde ve postoperatif altıncı ayda arter kan gazı, solunum fonksiyon testi ve ekokardiyografik incelemeleri yapıldı. Bulgular: Her iki grupta da operasyon sonrası FEV1 ve FVC değerlerinde anlamlı düşme saptandı (p<0.05). Fakat gruplardaki operasyon öncesi ve sonrası pCO2 ve pO2 değerleri arasında anlamlı fark yoktu (p>0.05). Lobektomi grubunda; operasyonun hem sol, hem de sağ kalp fonksiyon ve basınçlarında istatistiksel olarak anlamlı bir değişiklik yapmadığı saptandı (p>0.05). Pnömonektomi grubundaysa; pulmoner arter basıncı (operasyon öncesi 27.80±11.10, operasyon sonrası 33.20±8.10, p=0.011), sağ ventrikül çapı (operasyon öncesi 22.40±0.78, operasyon sonrası 24.50±1.81, p=0.011) ve triküspit kapak velositesi (operasyon öncesi 2.08±0.57, operasyon sonrası 2.37±0.42, p=0.010) altıncı ayın sonunda istatistiksel olarak anlamlı bir yüksekliğe ulaşırken, sol kalp ölçümlerinde değişiklik izlenmedi (p>0.05). Sonuç: Ekokardiyografi kardiyak fonksiyonların değerlendirilmesinde kullanılabilen kalp kateterizasyonu ve radyonüklid ventrikülografiye göre daha pratik, ucuz ve invaziv olmayan bir yöntemdir. Pnömonektomi sonrası sağ ventrikül modifikasyonlarının belirgin olması, mümkün olduğu kadar pnömonektomiden kaçınmamız gerektiğini ortaya koymuştur.
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  • 1
15-18
  • Turkish

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