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目的：探讨食管癌病人术前肺功能与双腔管全麻双侧和单侧通气状态下气道阻力的相关性。方法：９３例食管癌病人依据术前肺功能分为３组；正常组５１例（％ＶＣ≥８０％、％ＦＥＶ１≥７０％、％Ｖ２５／ＨＴ≥５０％），轻度异常组１５例（％ＶＣ≥８０％、％ＦＥＶ１≥７０％、％Ｖ２５／ＨＴ为４５％～４９％）；重度异常组２７例（％ＶＣ≥８０％、％ＦＥＶ１＜７０％、％Ｖ２５／ＨＴ＜４５％）。结果：小气道功能重度异常组的病人其单侧、双侧通气时初始气道阻力明显高于小气道功能正常组且术中波动较大，两组间差异非常显著（Ｐ＜０．０１）；术后心肺并发症（２２．２％）明显高于正常组（０）及轻度异常组（６．６％）。结论：在预测双腔管全麻下气道阻力变化的小气道功能指标中以％ＦＥＶ１可靠性较好，而％Ｖ２５／ＨＴ因较敏感而可靠性较差。
Objective: To investigate the correlation between preoperative pulmonary function and airway resistance under double-sided and unilateral ventilation in patients with esophageal cancer. METHODS: Ninety-three patients with esophageal cancer were divided into three groups according to preoperative pulmonary function; 51 patients in the normal group (%VC≥80%, %FEV1≥70%, %V25/HT≥50%), and 15 patients with mild abnormalities ( %VC≥80%, %FEV1≥70%, %V25/HT, 45%～49%); Severe abnormal group, 27 cases (%VC≥80%, %FEV1<70%, %V25/HT<45%) . Results: In patients with severe airway dysfunction, the initial airway resistance was significantly higher in the unilateral and bilateral ventilation group than in the small airway function group and the intraoperative fluctuations were significant. The difference between the two groups was very significant (P<0.01). Postoperative cardiac and pulmonary complications (22.2%) were significantly higher than those in the normal (0) and mildly abnormal groups (6.6%). Conclusion: The reliability of %FEV1 is better in predicting small airway function indexes of airway resistance changes under double anesthesia, and %V25/HT is more sensitive and less reliable.