肺癌术后呼吸功能衰竭高危因素临床分析

Risk Factors of Post-operation Failure in Patients With Lung Cancer.

目的 探讨肺癌术后发生呼吸功能衰竭的高危因素。方法 实验组采用肺癌术后呼吸衰竭21例,并以同期肺癌手术未发生呼衰的84例作为对照组,用x^2检验。结果 术后呼衰组的术前肺功能指标,如肺活量占预计值百分比(VC％)、最大通气量占预计值百分比(MVV％)、第一秒呼气容积(FEV1.0)、第一秒呼气量占用力肺活量百分比(FEV1.0/FVC％)等均明显低于无呼衰组。根据手术方式分析,袖式肺叶切除、肺叶切除组的呼衰发生率均低于全肺切除组。肺癌术后肺部感染亦导致呼衰发生率增高。结论 肺功能下降、术后肺部感染是肺癌术后呼吸功能衰竭的高危因素。肺功能较差的病人应尽量避免全肺切除。

Objective:To analyze the risk factors of post-operative respiratory failure in patients with lung cancer. Methods: 21 cases of lung cancer with post-operative respiratory failure and 84 controls were analyzed by x2 analysis. Results; VC% , MVV, FEV1.0, FEV1.0/FVC% in respiratory failure group were significantly lower than those in control group (P<0.05). the odds of respiratory failures were much lower in sleeve resection and lobectomy group than those in pneumonectomy group. Conclusion: Lower pulmonary function, postoperative pulmonary infection and pneumonectomy are the risk factors of post-operative respiratory failure in lung cancer. Pneumonectomy should be avoid to those patients whose pulmonary function was too low.