中国肿瘤临床
中國腫瘤臨床
중국종류림상
CHINESE JOURNAL OF CLINICAL ONCOLOGY
2015年
7期
397-400
,共4页
肺癌%全肺切除%低肺功能%术后并发症
肺癌%全肺切除%低肺功能%術後併髮癥
폐암%전폐절제%저폐공능%술후병발증
lung neoplasm%pneumonectomy%low pulmonary function%postoperative complications
目的：探讨肺癌患者术前轻度低肺功能对左全肺切除术后心肺并发症（postoperative cardiopulmonary complication， PCC）的预测能力，以期作为指导临床手术参考。方法：回顾性分析我院200例施行左全肺切除手术的肺癌患者的临床资料，根据患者术后1个月内有无发生心肺并发症分为PCC组和无PCC组，探讨术前轻度或中重度低肺功能与患者术后并发症发生的相关性，并进一步探讨肺通气功能指标（FEV1%、MVV%）轻度减低与术后PCC的关系。结果：200例患者中正常、轻度及中重度肺功能减低各35、45、120例，术后1个月内PCC发生率分别为28.6%，53.3%，62.5%，差异具有统计学意义（χ2=12.611，P=0.002）；术前FEV1%轻度减低（70%≤FEV1<80%）或MVV%轻度减低（70%≤MVV%<80%）与左全切术后PCC的发生相关（P=0.028及0.014）。进一步分析显示，FEV1%或MVV%单独轻度减低时，患者术后PCC的发生差异无统计学意义（P>0.05），而FEV1和MVV同时轻度减低时，PCC的发生差异有统计学意义（χ2=6.598，P=0.010）。结论：术前FEV1%或MVV%轻度减低是影响肺癌左全肺切除后PCC的危险因素。FEV1%或MVV%单独轻度减低不能影响肺癌左全肺切除后PCC的发生，同时满足FEV1%及MVV%轻度减低是肺癌左全切术后PCC发生的危险因素，应加强围手术期管理，降低PCC的发生。
目的：探討肺癌患者術前輕度低肺功能對左全肺切除術後心肺併髮癥（postoperative cardiopulmonary complication， PCC）的預測能力，以期作為指導臨床手術參攷。方法：迴顧性分析我院200例施行左全肺切除手術的肺癌患者的臨床資料，根據患者術後1箇月內有無髮生心肺併髮癥分為PCC組和無PCC組，探討術前輕度或中重度低肺功能與患者術後併髮癥髮生的相關性，併進一步探討肺通氣功能指標（FEV1%、MVV%）輕度減低與術後PCC的關繫。結果：200例患者中正常、輕度及中重度肺功能減低各35、45、120例，術後1箇月內PCC髮生率分彆為28.6%，53.3%，62.5%，差異具有統計學意義（χ2=12.611，P=0.002）；術前FEV1%輕度減低（70%≤FEV1<80%）或MVV%輕度減低（70%≤MVV%<80%）與左全切術後PCC的髮生相關（P=0.028及0.014）。進一步分析顯示，FEV1%或MVV%單獨輕度減低時，患者術後PCC的髮生差異無統計學意義（P>0.05），而FEV1和MVV同時輕度減低時，PCC的髮生差異有統計學意義（χ2=6.598，P=0.010）。結論：術前FEV1%或MVV%輕度減低是影響肺癌左全肺切除後PCC的危險因素。FEV1%或MVV%單獨輕度減低不能影響肺癌左全肺切除後PCC的髮生，同時滿足FEV1%及MVV%輕度減低是肺癌左全切術後PCC髮生的危險因素，應加彊圍手術期管理，降低PCC的髮生。
목적：탐토폐암환자술전경도저폐공능대좌전폐절제술후심폐병발증（postoperative cardiopulmonary complication， PCC）적예측능력，이기작위지도림상수술삼고。방법：회고성분석아원200례시행좌전폐절제수술적폐암환자적림상자료，근거환자술후1개월내유무발생심폐병발증분위PCC조화무PCC조，탐토술전경도혹중중도저폐공능여환자술후병발증발생적상관성，병진일보탐토폐통기공능지표（FEV1%、MVV%）경도감저여술후PCC적관계。결과：200례환자중정상、경도급중중도폐공능감저각35、45、120례，술후1개월내PCC발생솔분별위28.6%，53.3%，62.5%，차이구유통계학의의（χ2=12.611，P=0.002）；술전FEV1%경도감저（70%≤FEV1<80%）혹MVV%경도감저（70%≤MVV%<80%）여좌전절술후PCC적발생상관（P=0.028급0.014）。진일보분석현시，FEV1%혹MVV%단독경도감저시，환자술후PCC적발생차이무통계학의의（P>0.05），이FEV1화MVV동시경도감저시，PCC적발생차이유통계학의의（χ2=6.598，P=0.010）。결론：술전FEV1%혹MVV%경도감저시영향폐암좌전폐절제후PCC적위험인소。FEV1%혹MVV%단독경도감저불능영향폐암좌전폐절제후PCC적발생，동시만족FEV1%급MVV%경도감저시폐암좌전절술후PCC발생적위험인소，응가강위수술기관리，강저PCC적발생。
Objective:To investigate the value of preoperative slight decline of the pulmonary function in predicting postoperative cardiopulmonary complications (PCC) after left total pneumonectomy of lung cancer patients to guide the clinical surgery of lung can-cer. Methods:Clinical data of 200 lung cancer patients after left total pneumonectomy were retrospectively analyzed. These patients were divided into two groups (PCC and non-PCC) based on the incidence of postoperative cardiopulmonary complications within 1 month after the cancer resection. The relationship between the preoperative slight or moderate to severe reduction of pulmonary func-tion and postoperative complications was explored. The correlation between the preoperative slight decline of the pulmonary function index and PCC was also analyzed. Results:Among the 200 patients, 35, 45, and 120 demonstrated normal, slightly, and moderately to severely reduced pulmonary functions, and 28.6%, 53.3%, and 62.5% showed PCC within 1 month after the surgical resection (χ2=12.611, P=0.002). Significant differences in the slightly reduced pulmonary function parameters MVV% (70% ≤ MVV<80%) and FEV1%(70%≤FEV 1%<80%) were observed between those without and with complications (P=0.028 and 0.014). Further analysis indicated no significant difference between the patients with preoperative slight reduction of FEV1%only or of MVV%only (P>0.05). However, statistically significant differences were observed when both FEV1%and MVV%were slightly reduced (χ2=6.598, P=0.010). Conclusion:The preoperative slight reduction values of FEV1%and MVV%were the risk factors in predicting PCC after left pneumo-nectomy in lung cancer patients. The slightly reduced FEV1%or MVV%alone cannot influence PCC. Both slightly reduced FEV1%and MVV%were the risk factors of PCC. Perioperative management should be strengthened for these patients to lower the incidence of PCC.
