抄録
A clinical study was made on 76 patients who had been hospitalized over one year after the operation and whose vital capacities were less than 50% of the normal.
The degree of their subjective dyspnea were examined according to the Sasamoto's classification, and 34 patients (44.7% of the total) complained of severe dyspnea, more than 5th degree, Right heart loading on the postoperative electrocardiogram was found in 34 cases (44.7% of all cases), and these findings were correlated to 'the decrease of 96 VC. The cases with right heart loading increased remarkably when % VC lowered below 40%. The degree of dyspnea were also correlated to the decrease of % VC and % MBC, although they were not so intimately related to % FEV, C. V. I., RV/TLC and the rate of oxygen removal. Analysing the arterial gas in these cases, PH showed alkalosis at rest, PO2 indicated below 80mmHg and PCO2 40mmHg mostly. PO2 and PCO2 were correlated to the degree of dyspnea and the findings of right heart loading on EKG, therefore PO2 and PCO2 will be a good index for postoperative cor pulmonale.
Concerning the operative me, bilateral surgical treatment, left thoracoplasty and pay with thoracoplasty must be carefully carried out because of the worse results of pulmonary function, arterial blood gas analysis and electrocardiogram postoperatively. Particularly, thoracoplasty after pneumonectomy should not be enforced.
Maity of these postoperative cor pulmonale occured about three years after the operation, so the clinical observation by electrocardiogram and arterial blood gas analysis must be continued for long term and adequate guidance and treatment for the patients should be done to prevent the cor pulmonale.
