超声心动图用于肺切除术围手术期并发症的 监测研究进展

Research Progress on the Application of Echocardiography in Monitoring Perioperative Complications of Pulmonary Resection

摘要: 肺手术是目前全球范围内针对肺部占位性疾病有效且常用的诊疗手段。随着胸腔镜下肺切除术技术的日益成熟，肺切除的范围与方式也日趋多样化。尽管手术技巧及术后监护水平显著提高，但肺切除术后心血管并发症的发生率仍高达25%，其中以围手术期心肌损伤和术后心房颤动最为常见。动物实验及临床病例分析均证实，肺切除术后早期右心功能会发生显著改变，主要表现为肺动脉平均压升高、右心室舒张末期容积增加，以及右室射血分数、右室每搏输出量和右心输出量的降低。鉴于肺癌患者肺切除术后心脏结构和功能的变化难以管理，应用超声心动图评估术后心功能变化至关重要，对于进一步的临床观察具有重要的指导价值。

Abstract: Lung surgery remains a globally recognized and effective diagnostic and therapeutic approach for pulmonary space-occupying diseases. With the continuous advancement of thoracoscopic techniques, the scope and methods of pulmonary resection have become increasingly diverse. Despite significant improvements in surgical precision and postoperative monitoring, the incidence of cardiovascular complications following pulmonary resection remains as high as approximately 25%, with perioperative myocardial injury and postoperative atrial fibrillation being the most prevalent. Both animal studies and clinical case analyses have confirmed that right ventricular function undergoes significant alterations in the early postoperative phase, primarily characterized by elevated mean pulmonary arterial pressure, increased right ventricular end-diastolic volume, and reduced right ventricular ejection fraction, right ventricular stroke volume, and right cardiac output. Given the challenges in managing postoperative structural and functional cardiac changes in lung cancer patients following pulmonary resection, echocardiographic assessment of cardiac function dynamics is critically important and provides essential guidance for subsequent clinical monitoring and decision-making.