Right Ventricular Function In Patients With Pulmonary Resection Of Peri-surgical Period Evaluation By Real-time Three-dimensional Echocardiography

Objective:Application of real-time three-dimensional echocardiography in patientsbefore lung resection and early postoperative right heart function changes, toexplore the clinical value of real-time three-dimensional echocardiography in theevaluation of right ventricular function in patients with pulmonary resection ofperi-operation period.Materials and methods:Selected51cases of pneumonectomy patients as the basic object of studyin our hospital between January to October in2014, including14patients withpulmonary wedge resection,27cases of pulmonary lobectomy patients and10cases of unilateral total lung resection patients. In the preoperative1-2days andpostoperative3-5days three groups of patients produced by Philips companyIE33color Doppler ultrasonic diagnostic apparatus, equipped with x3-13Dprobe.We will get ideal right ventricular image in apical four chamber view of theheart, then start full-volume imaging mode, the ECG can trigger, acquisition forfour cycles of pyramid shaped3D data.Use of3D graphics Qlab7.03DAdvsoftware to carry on the analysis, construction of right ventricular volumethree-dimensional model, measure Right Ventricular end-diastolic volume(RVEDV), right ventricular end-systolic volume (RVESV), right ventricular strokevolume (RVSV), right ventricular ejection fraction (RVEF). Tissue Dopplerimaging of the RV was performed in the apical four-chamber view. The icuspidsystolic peak velocity(Sm),the tricuspid valve early diastolic peakvelocity(Em),the tricuspid valve late diastolic peak velocity(Am) were measuredin lateral RV wall,and calculate the Tei index. The arameters of each group ofpreoperative and postoperative values were self contrast; pulmonary wedgeresection, lobectomy group group of every parameter and the pneumonectomygroup were compared.Result：1Postooperation the parameters numerical of three groups werecompared preperative had no statistical significance (P>0.05). 2Pulmonary wedge resection group postooperation the right volume andright ventricular function In than preoperation had no obvious change.Lobectomy and Unilateral total lung resection group postoperative the rightventricular end-diastolic volume (RVEDV), end-systolic volume (ESV) increased,the stroke volume (SV), ejection fraction (EF) decreased, there were significantdifference compared with the preoperative (P<0.05). Unilateral total lungresection group than the lobe resection group and Pulmonary wedge resectiongroup had more obvious changes (P<0.05).3Wedge resection group postooperation Sm, Em/Am, Tei index thanpreoperation had no obvious change. Lobectomy and Unilateral total lungresection group postooperation Sm, Em/Am reduction, Tei index increased,there were significant difference compared with the preoperative (P<0.05).Unilateral total lung resection group than the lobe resection group andPulmonary wedge resection group had more obvious changes (P<0.05).Conclusion:1Real-time three-dimensional echocardiography can quickly, accurate,non-invasive measurement of right ventricular volume and right ventricularfunction. It provide method and reliable diagnosis for assessmention the rightventricular function in peri-operative period of pulmonary lobectomy patients. Ithas clinical significance to the treatment and evaluation of prognosis.2Tissue Doppler imaging can evaluate the early right ventricular functionchanges after pulmonary resection.3Tei index can regarded as an effectively assist index for assessment theoverall right ventricular function after Pneumonectomy resection.