静息肺功能评估肺癌术后呼吸衰竭的应用价值分析

目的探究静息肺功能评估肺癌患者术后呼吸衰竭的临床应用价值。方法选取40例肺癌患者作为试验组,患者均于肺癌术后出现呼吸衰竭。同时选取100例肺癌术后未出现呼吸衰竭的患者作为对照组,分析比较2组患者的临床指标(性别、年龄、吸烟史、并发症、肿瘤灶位置、病灶长度、切除范围、术前肺功能、手术输液量、手术时间)及静息肺功能指标(VC%、FVC%、FEV1%、FEV1/FVC%、FEV1/VC%、PEF%、FEF25%、FEF50%、FEF75%、MMEF%、MVV%)(肺活量、用力肺活量、第一秒用力呼气容积、第一秒用力呼气量占用力肺活量比值、第一秒用力呼气量占肺活量比值、呼气峰值流速、呼吸早期瞬间流速、呼吸中期瞬间流速、呼吸晚期瞬间流速、最大呼气中期流速、最大自主分钟通气量),并采用回归分析探究影响肺癌术后呼吸功能衰竭的影响因素。结果 2组患者年龄、吸烟史、合并COPD(慢性阻塞性肺病)、手术时间、术中输液量、术前肺功能、切除部位等临床指标相比差异有统计学意义(P<0.05)。2组患者VC%、FVC%、FEV1%、PEF%、FEF25%、FEF50%、MMEF%、MVV%等静息肺功能指标相比差异有统计学意义(P<0.05),FEV1/FVC%、FEV1/VC%、FEF75%相比差异无统计学意义。Logistic回归分析显示,年龄、合并COPD、术前肺功能、术中输液量及全肺切除是危险因素。结论静息肺功能指标能作为评价肺癌患者术后呼吸功能的指标,且年龄、合并COPD、术前肺功能、术中输液量及全肺切除是影响呼吸衰竭的危险因素。

Objective To explore the clinical value of resting lung function on assessing postoperative respiratory failure in patients with lung cancer. Methods 40 lung cancer patients with respiratory failure were selected in lung cancer surgery for the study, 100 lung cancer patients without respiratory failure were selected as control group. Clinical parameters and resting lung function were analyzed ,and explore the impact of the use of factors of respiratory failure after lung cancer regression analysis. Results Age, smoking history, merge COPD, operative time, intraoperative fluid volume, preoperative lung function, removal parts had statistically significant difference （P〈0.05）. There was a statistically significant difference on VC%, FVC%, FEV 1%, PEF%, FEF25%, FEF 50%, MMEF%,MVV% （Vital capacity,Forced vital capacity,Forced expiratory volume in one second, Peak expiratory flow, Forced expiratory flow 25%, Forced expiratory flow 50%, Maximal mid-expiratory flow, Maximal voluntary ventilation）（P〈0.05）.Logistic regression analysis showed age, merger COPD （chronic obstructive pulmonary disease）, preoperative pulmonary function, intraoperative fluid volume and total lung resection was a risk factor of respiratory failure. Conclusion Resting lung function in patients with lung cancer could be used as the evaluation index of postoperative respiratory function. Age, merger COPD, preoperative pulmonary function, intraoperative fluid volume and total lung resection was a risk factor of respiratory failure.