肺切除患者术前心肺功能与术后肺部并发症关系的研究

Evaluation of cardiopulmonary function in postoperative pulmonary complications of lung resection surgery

目的探讨肺叶切除术患者术前心肺功能与术后发生肺部并发症的关系。方法对115例肺切除手术患者进行术前肺功能检测,检测项目有常规肺通气功能、弥散功能和肺容量。部分病人进行了运动心肺功能试验。对术后有无发生肺部并发症两组心肺功能进行比较分析。结果115例肺切除患者术后PPC的发生率为24.4%。PPC组FVC% pred(85.8±20.7)、FEV1% pred(79.6±24.2)明显低于正常对照组(P<0.05)。运动心肺功能试验中PPC组VO2max/kg(19.28±4.65)mL/(min·kg)、VO2max% pred(48.65±11.34)、WRmax% pred(63.29±14.13)、VO2/HRmax% pred(65.06±15.04)明显低于正常对照组(P<0.05,P<0.01)。结论肺切除患者术前心肺功能评估对减少术后并发症的发生,减少围手术期的死亡率是非常重要的。

[Objective ] To investigate the value of preoperative cardiopulmonary function in predicting postoperative pulmonary complications of lung resection. [Methods] Routine respiratory ventilation function were performed in 115 patients with lung carcinoma. 66 of them were performed by eardiopulmonary exercise test （CPET）. Postoperative pulmonary complications （PPC） in 115 patients within 1 month of carcinoma resection was observed. Analyze the cardiopulmonary function testing parameters synthetically, assessing the tolerance of lung resection and PPC. [Results] PPC developed in 28 patients （24.4%）. There were significant differences in pulmonary function parameters, such as FVC %pred and FEVI%/pred between those who experienced complications （85.8±20.7）, （79.6±24.2） and those without complications （P 〈0.05）; in eardiopulmonary exercise test （CPET）, there were significant differences parameters, such as V02 max/kg,VO2 max%pred, WIt max%pred, VO-,/HR max%pred between those who experienced complications （19.28±4.65） mL/（min-kg）, （48.65±11.34） （63.29±14.13） （65.06±15.04） and those without complications （P 〈0.05）. There were no significant differences in age between those who did and those who did not experience complications. [ Conclusion] Preoperative pulmonary function is very important, it could assess tolerance and postoperative pulmonary complication happening of lung resection surgery .