肺通气功能测定及血气分析与食道贲门癌术后肺部并发症的关系

Relationship between pulmonary function as well as the indexes of aterial blood-gas and post-operative pulmonary complications of the esophagus and cardia carcinoma

目的分析食道、贲门癌患者术前肺通气功能及血气分析状况对术后肺部并发症的影响。方法242例食道、贲门癌患者术前均行肺通气功能测定及血气分析。设肺功能正常者(152例)为A组;肺功能异常者(90例)为B组;肺功能及血气均正常者(145例)C组;肺功能及血气均异常者(31例)D组,分别比较其术后肺部并发症情况;同时分析肺功能、血气相关指标与肺部并发症的关系。结果B组肺部并发症率高于A组,差异有统计学意义(P<0.05);D组肺部并发症率明显高于C组,差异有统计学意义(P<0.01)。术前FVC、FEV1、MMV、FEE75<70%预测值,SaO2<95%、PaCO2>45 mmHg时肺部并发症明显增加。结论经胸食管贲门癌根治术前,患者均应常规行肺通气功能测定和血气分析。FVC、FEV1、MMV、FEE75、SaO2、PaCO2与术后肺部并发症有关,FEV1/FVC、FEE25未显示其相关性。

Objective To investigate the value of preoperative respiratory ventilation function and indexes of aterial blood-gas in predicting postoperative pulmonary complications of the esophagus and cardia carcinoma.Methods Respiratory ventilation function and indexes of aterial blood-gas were performed on 242 patients with esophagus-cardiac carcinoma.Preoperative pulmonary function of 152 cases（group A） was normal;the other 90 cases accompanying pulmonary disfunction were included into group B.145 cases（group C） showed normal pulmonary function and indexes of aterial blood-gas while 31 cases（group D）indicated abnormal pulmonary function and indexes of aterial blood-gas.The relationship between pulmonary function,the indexes of aterial blood-gas and post-operative pulmonary complications was analyzed.Results The incidence of pulmonary complications in group B was higher than in group A,which showed variance statistically（P0.05）.The incidence of pulmonary complications in group D was much higher than in group C,which showed variance statistically（P0.01）.The incidence of pulmonary complications increased a lot when FVC,FEV1,MMV,FEE75were75%,or SaO295%,or PaCO245 mmHg.Conclusion A routine respiratory ventilation function test and blood-gas analysis are necessary for patients with esophagus-cardiac carcinoma.The pulmonary complications are related to FEV1,MMV and FEE75 except SaO2 and PaCO2.