术前呼气峰流量与胸腔镜肺癌手术后肺部并发症的相关性及预测价值

Correlation of preoperative peak expiratory flow with postoperative pulmonary complications after thoracoscopic lung cancer surgery and its predictive value

目的 探讨术前呼气峰流量与肺癌术后肺部并发症之间的相关性及PEF作为可能的预测因素对PPCs发生的预测价值。方法 回顾性分析2018年12月~2020年6月莆田市第一医院胸外科233例接受肺癌手术的患者,记录相关临床资料,分析PEF与肺部感染、肺不张、肺栓塞、持续性肺漏气等术后肺部并发症之间的相关性,并进一步分析其预测价值。结果 单因素分析显示PPCs组的PEF值[(4.68±1.51)L/s]显著低于Non-PPCs组[(6.33±1.71)L/s](P<0.001);Logistic回归分析显示PEF是预测PPCs的独立危险因素;基于ROC曲线分析,PEF阈值为5.64 L/s是预测PPCs发生的最佳临界值(AUC=0.760,95%CI:0.690~0.830),且PEF≤5.64 L/s组的PPCs发生率均显著高于PEF>5.64 L/s组(41.6%vs. 10.6%,P<0.001)。结论 术前PEF和PPCs有一定的相关性,PEF有可能成为PPCs发生的预测因素。

Objective To investigate the correlation of preoperative peak expiratory flow(PEF) with postoperative pulmonary complications(PPCs) in lung cancer, and the potential value of PEF in predicting the occurrence of PPCs.Methods A total of 233 patients undergoing lung cancer surgery in the Department of Cardiothoracic Surgery in The First Hospital of Putian City from December 2018 to June 2020 were retrospectively analyzed. The relevant clinical data were recorded, the correlation between preoperative PEF and PPCs such as pulmonary infection, pulmonary atelectasis, pulmonary embolism, and prolonged pulmonary air leak were analyzed, and the predictive value was further analyzed. Results Univariate analysis showed that preoperative PEF value of the PPCs group(4.68±1.51) L/s was significantly lower than that of the Non-PPCs group(6.33±1.71) L/s(P<0.001). The logistic regression analysis showed that preoperative PEF value was an independent risk factor for predicting the occurrence of PPCs. The receiver operating characteristic(ROC) curve analysis revealed that a preoperative PEF threshold of 5.64 L/s was the best threshold value to predict the occurrence of PPCs [area under the ROC curve(AUC)=0.760, 95%CI: 0.690-0.830], and the incidence of PPCs in the group with PEF≤5.64 L/s was significantly higher than that in the group with PEF >5.64 L/s(41.6% vs.10.6%, P<0.001). Conclusion There is a correlation between preoperative PEF value and PPCs, and PEF has the potential to be a predictor of the occurrence of PPCs.