肺癌病人术后呼吸衰竭的预测

Prediction of Postoperative Respiratory Failure in Patients Undergoing Lung Resection for Lung Cancer

肺癌手术病例以正侧位胸部平片、纤支镜检查结果简便的方法评估预测术后肺功能和术后呼衰的关系。分析术后急性呼衰24例，预测术后肺功能（F）用下述公式求得：F＝［1-（b-n）／（42-n）］×f，式中f为术前常规肺功能检查VC或FEV1值，b是手术切除肺组织的亚段数，n是肺癌所占居或阻塞的亚段数，全肺亚段数42，右肺22，左肺20．预测术后％VC＝预测术后VC／正常VC，预测术后％FEV1＝预测术后FEV1／正常FEV1。符合以下两项者：百分率VC＜60％，百分率FEV1＜40％12例。单独以百分率FEV1＜40％计，15例。预测术后肺功能在此范围者属高危病人，尤其以百分率FEV1更能反应术后并发急性呼衰的可能，此类病例必须事先做好术后呼吸道管理的准备，以利安度术后危险关。

To evaluate the correlation between predicted postoperative lung function and postoperative respi-ratory failure, 24 petients with lung cancer who underwent resection were analysed by the findings on the chesttomogram, at bronchofiberscopy, or a combination of these. The predicted postoperative lung function (F) was as-sessed by the formula F= [1-(b-n)/(42-n)]×f, where f is the preoperative vital or forced expiratory volume in onesecond, b is the number of subsegtnente of the resected lung, and n is the number of subsegments obstructed bythe tumor. The total number of subsegments was assamed to be 42, (right 22, left 20). The predicted postoperative% FEV1=predicted poatophative FEV1/normal FEV1, predicted postoperative % VC=predicted postoperative VC/normal VC. 12 patiente were % VC<60%,%FEV1<40%. 15 patients were % FEV1<40%. Therefore, we believe thata predicted postoperative % VC<60,% FEV1<40%, special %FEV1 <40%, indicated a high risk of respiratory fai-lure after lung resection.