肺癌患者微创切除术前肺功能与术后肺部并发症的关系  

The relationship between preoperative lung function and postoperative pulmonary complications in patients with lung cancer

作　　者：阙呈立[1] 李简[1] 李雪迎[1] 李小玲[1] 罗义萍[1] 赵桂荣[1] 

机构地区：[1]北京大学第一医院呼吸内科,北京100034

出　　处：《中国综合临床》2008年第3期248-251,共4页Clinical Medicine of China

摘　　要：目的探讨术前肺功能与微创肺癌切除术后肺部主要并发症的关系。方法时2005年1月至2007年6月我院胸外科接受微创肺癌切除术的227例患者临床资料进行回顾分析。肺功能参数为用力呼气第一秒呼气容量（FEV1）占预计值的百分比和一氧化碳弥散量（DLco）占预计值的百分比等。结果227例肺癌患者，行单恻全肺切除48例，肺叶切除169例，肺影楔形切除10例。23例患者于术后出现了肺部主要并发症，发生率为10．1％（23／227），其中3例死亡；55例（24。2％）胸腔引流超过7d。发生与未发生并发症患者的FEV1占预计值百分比分别为（93．23±21．64）％和（94．77±20.00）％，DLco占预计值百分比分别为（79．09±22．28）％和（85．21±19．23）％，差异均无统计学意义（均P〉0．05）。多元线性回归显示DLco占预计值百分比与引流延长及主要并发症呈负相关（P=0．04），Logistic回归分析示DLco占预计值百分比与引流廷长及主要并发症的OR值为0。985（P=0．093）。结论微创肺癌切除术前肺功能测定仅能预测一部分患者术后肺部并发症的发生，DLco对预测术后肺部主要并发症和延迟拔除胸管有意义。Objective To explore the relationship between preoperative lung function and postoperative pulmonary complications in patients with lung cancer. Methods The clinical data of 227 cases receiving lung resection surgery for lung cancer between January 2005 and June 2007 were retrospectively analyzed. Results Among 227 patients with lung cancer,48 had pneumonectomy, and 169 had lobectomy and 10 segmentectomy/wedge resection. During the hospital stay,23 （10.1% ） patients with lung cancer had major pulmonary complications postoperatively, in whom 3 patients died eventually,55 patients （24.2% ） had drainage for more than 7 days. There were neither significant differences FEV1% predicted nor DLco% predicted between patients with and without major complications, which were （ 93.23 ± 21.64 ） % vs （ 94.77 ± 20.00 ） %, and （ 79.09 ± 22.28 ） % vs （ 85.21 ± 19.23 ） % respectively （P 〉 0.05 ）. Multiple linear regression revealed that there was a negative correlation between preoperative DLco% predicted and prolonged drainage and major pulmonary complication （ P = 0. 093 ）. Conclusion Preoperative lung function tests can identify some high risk patients for major pulmonary complications. DLco is a useful parameter in preoperative pulmonary assessment.

关 键 词：肺癌 肺切除术 肺功能 

分 类 号：R734.2[医药卫生—肿瘤]