中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2013年
9期
827-830
,共4页
胡荣贵%傅剑华%罗孔嘉%张旭%杨弘%刘孟忠%刘慧%李群%胡永红
鬍榮貴%傅劍華%囉孔嘉%張旭%楊弘%劉孟忠%劉慧%李群%鬍永紅
호영귀%부검화%라공가%장욱%양홍%류맹충%류혜%리군%호영홍
食管肿瘤%术前放化疗%肺功能%肺部并发症
食管腫瘤%術前放化療%肺功能%肺部併髮癥
식관종류%술전방화료%폐공능%폐부병발증
Esophageal neoplasms%Preoperative chemoradiotherapy%Pulmonary function%Postoperative pulmonary complications
目的 探讨术前放化疗对食管癌患者肺功能及术后肺部并发症的影响.方法 回顾性收集2002-2013年间中山大学肿瘤防治中心连续收治的术前同期放化疗并手术治疗的63例食管鳞癌患者放化疗前后肺功能指标及其术后肺部并发症的发生情况,分析放化疗前后肺功能的各项指标的变化及其对术后肺部并发症的影响.结果 放化疗后,63例患者一氧化碳弥散量(DLco％)较治疗前明显降低(83.7±17.7比96.4±17.8,P＜0.01),而其他肺功能指标均未见明显变化(P＞0.05).术后肺部并发症发生率为34.9％(22/63),其中肺炎19例,急性肺损伤/急性呼吸窘迫综合征3例.术前肺弥散功能正常者(DLco％大于或等于80)和异常者(DLco％小于80),术后肺部并发症发生率的差异无统计学意义[29.7％(11/37)比41.7％(10/24),P=0.338].放疗后DLco％明显下降者(DLco％下降大于或等于15％)和无明显下降者(DLco％下降小于15％),术后肺部并发症发生率的差异亦无统计学意义[31.6％(6/19)比37.8％(14/37),P=0.664].结论 术前放化疗会降低食管癌患者肺弥散功能,但并不损伤肺通气功能,亦不会增加术后肺部并发症发生率.
目的 探討術前放化療對食管癌患者肺功能及術後肺部併髮癥的影響.方法 迴顧性收集2002-2013年間中山大學腫瘤防治中心連續收治的術前同期放化療併手術治療的63例食管鱗癌患者放化療前後肺功能指標及其術後肺部併髮癥的髮生情況,分析放化療前後肺功能的各項指標的變化及其對術後肺部併髮癥的影響.結果 放化療後,63例患者一氧化碳瀰散量(DLco％)較治療前明顯降低(83.7±17.7比96.4±17.8,P＜0.01),而其他肺功能指標均未見明顯變化(P＞0.05).術後肺部併髮癥髮生率為34.9％(22/63),其中肺炎19例,急性肺損傷/急性呼吸窘迫綜閤徵3例.術前肺瀰散功能正常者(DLco％大于或等于80)和異常者(DLco％小于80),術後肺部併髮癥髮生率的差異無統計學意義[29.7％(11/37)比41.7％(10/24),P=0.338].放療後DLco％明顯下降者(DLco％下降大于或等于15％)和無明顯下降者(DLco％下降小于15％),術後肺部併髮癥髮生率的差異亦無統計學意義[31.6％(6/19)比37.8％(14/37),P=0.664].結論 術前放化療會降低食管癌患者肺瀰散功能,但併不損傷肺通氣功能,亦不會增加術後肺部併髮癥髮生率.
목적 탐토술전방화료대식관암환자폐공능급술후폐부병발증적영향.방법 회고성수집2002-2013년간중산대학종류방치중심련속수치적술전동기방화료병수술치료적63례식관린암환자방화료전후폐공능지표급기술후폐부병발증적발생정황,분석방화료전후폐공능적각항지표적변화급기대술후폐부병발증적영향.결과 방화료후,63례환자일양화탄미산량(DLco％)교치료전명현강저(83.7±17.7비96.4±17.8,P＜0.01),이기타폐공능지표균미견명현변화(P＞0.05).술후폐부병발증발생솔위34.9％(22/63),기중폐염19례,급성폐손상/급성호흡군박종합정3례.술전폐미산공능정상자(DLco％대우혹등우80)화이상자(DLco％소우80),술후폐부병발증발생솔적차이무통계학의의[29.7％(11/37)비41.7％(10/24),P=0.338].방료후DLco％명현하강자(DLco％하강대우혹등우15％)화무명현하강자(DLco％하강소우15％),술후폐부병발증발생솔적차이역무통계학의의[31.6％(6/19)비37.8％(14/37),P=0.664].결론 술전방화료회강저식관암환자폐미산공능,단병불손상폐통기공능,역불회증가술후폐부병발증발생솔.
Objective To study the influence of preoperative chemoradiotherapy (CRT) on pulmonary function and postoperative pulmonary complications in esophageal cancer patients.Methods Pulmonary function and postoperative pulmonary complications of 63 esophageal cancer patients undergoing preoperative CRT and operation in Cancer Center of Sun Yat-sen University between 2002 and 2013 were collected retrospectively.The influence of preoperative CRT on pulmonary functional indexes and postoperative pulmonary complications were analyzed.Results After preoperative CRT,DLco％ decreased significantly (83.7±17.7 vs.96.4±17.8,P＜0.01),while no obvious changes in other indexes were found.Postoperative pulmonary complication rate was 34.9％(22/63),including 19 cases of pneumonia and 3 cases of acute pulmonary injury/acute respiratory distress syndrome.Differences in postoperative pulmonary complication rates were not statistically significant between patients with DLco％ ＜80 and those with DLco％ ≥80 patients (29.7％ vs.41.7％,P＞0.05),and between patients with DLco％ decline ≥15％ and those with DLco％ decline ＜15％ patients (31.6％ vs.37.8％,P＞0.05).Conclusion Preoperative CRT can damage the diffusion function but not ventilation functio n of esophageal cancer patients,and does not increase the postoperative pulmonary complication rate.
