CAJ | 학술논문

目的：探讨非小细胞肺癌术后并发呼吸衰竭的危险因素,评估静息肺功能检测的临床价值。方法选择2012年1月—2014年5月在湖南省人民医院治疗的非小细胞肺癌并发呼吸衰竭60例为观察组,选择同期术后未发生呼吸衰竭的非小细胞肺癌120例为对照组。分别记录患者的一般资料,并对呼吸衰竭危险因素进行 logistic 回归分析,比较两组静息肺功能指标。结果两组年龄、吸烟率、合并慢性阻塞性肺疾病、术前肺功能、手术时间、切除范围及严重并发症发生率比较差异有统计学意义(P <0．05,P <0．01)。观察组静息肺功能指标肺活量、用力肺活量、第1秒用力呼气容积、最大自主通气量、用力呼气25%和50%肺活量瞬间流速、最大呼气流量和最大呼气中期流量均低于对照组(P <0．05,P <0．01)。年龄、术前肺功能障碍程度、全肺切除和术后严重并发症是非小细胞肺癌术后并发呼吸衰竭的高危因素(P <0．05,P <0．01)。结论针对非小细胞肺癌术后并发呼吸衰竭的高危因素,临床可以通过检测静息肺功能来评估患者呼吸功能,指导临床制定治疗方案。
목적：탐토비소세포폐암술후병발호흡쇠갈적위험인소,평고정식폐공능검측적림상개치。방법선택2012년1월—2014년5월재호남성인민의원치료적비소세포폐암병발호흡쇠갈60례위관찰조,선택동기술후미발생호흡쇠갈적비소세포폐암120례위대조조。분별기록환자적일반자료,병대호흡쇠갈위험인소진행 logistic 회귀분석,비교량조정식폐공능지표。결과량조년령、흡연솔、합병만성조새성폐질병、술전폐공능、수술시간、절제범위급엄중병발증발생솔비교차이유통계학의의(P <0．05,P <0．01)。관찰조정식폐공능지표폐활량、용력폐활량、제1초용력호기용적、최대자주통기량、용력호기25%화50%폐활량순간류속、최대호기류량화최대호기중기류량균저우대조조(P <0．05,P <0．01)。년령、술전폐공능장애정도、전폐절제화술후엄중병발증시비소세포폐암술후병발호흡쇠갈적고위인소(P <0．05,P <0．01)。결론침대비소세포폐암술후병발호흡쇠갈적고위인소,림상가이통과검측정식폐공능래평고환자호흡공능,지도림상제정치료방안。
Objective To analyze influencing factors of postoperative non-small-cell lung cancer patients with respiratory failure and to assess the clinical value of resting lung function. Methods General conditions of 60 postopera-tive non-small-cell lung cancer patients with respiratory failure (observation group) and 120 postoperative non-small-cell lung cancer patients without respiratory failure (control group) undergoing the operation during January 2012 and May 2014 were retrospectively recorded, and the influencing factors of respiratory failure underwent the multi-factor Logistic regression analysis, and then indexes of resting pulmonary function of the two groups were comparatively analyzed. Re-sults The differences in values of age, smoking rate, incidence rate of combined chronic obstructive lung disease, oper-ation time, preoperative lung function, cutting range and incidence rate of serious complications in the two groups were statistically significant (P < 0. 05, P < 0. 01). The indexes of vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in the first second (FEV1 ), maximal voluntary ventilation (MVV), forced expiratory vital capacity of 25% and 50% instantaneous velocity (FEF25% , FEF50% ), peak expiratory flow (PEF) and maximal expiratory medi-um flow (MMEF) in the observation group were significantly lower than those in the control group ( P < 0. 05, P <0. 01). Risk factors of postoperative non-small-cell lung cancer patients complicated with respiratory failure were age, preoperative degree of pulmonary dysfunction, pneumonectomy and postoperative serious complications (P < 0. 05, P <0. 01). Conclusion Clinicians should check indexes of resting lung function to evaluate the patients'respiratory function for postoperative non-small-cell lung cancer patients with respiratory failure so as to guide the clinical therapic plans.