心肺运动试验对预测肺癌患者术后呼吸衰竭的价值分析  

Value of Cardiopulmonary Exercise Test in Predicting Postoperative Respiratory Failure of Patients with Lung Cancer

作　　者：杨德松[1,2] 李旭[1,2] 唐金明[1,2] 吴劼[1,2] 吴智宁[1,2] 张百华[1,2] 周勇[1,2] 王文祥[1,2] 

机构地区：[1]中南大学湘雅医学院附属肿瘤医院 [2]湖南省肿瘤医院胸外二科,湖南长沙410013

出　　处：《临床医学工程》2015年第6期731-732,共2页Clinical Medicine & Engineering

摘　　要：目的探讨心肺运动试验对预测肺癌患者术后呼吸衰竭的临床价值。方法选择2013年6月至2014年3月在我院确诊为原发性肺癌并择期行肺癌切除手术的302例患者为研究对象,根据手术方式的不同将患者分为全肺叶切除组(40例)和肺叶切除组(262例),根据术后是否发生呼吸衰竭将两组患者分为RF组和NRF组。手术前应用运动负荷递增的方法对所有患者进行心肺运动试验,测定并记录患者终止负荷运动时的各项指标,对RF组和NRF组的结果进行统计学分析。结果全肺叶切除组患者中,RF组的心肺运动试验中VE、BF、VO2/kg、VO2%P、MET等指标均低于NRF组,差异具有统计学意义(P<0.05);RF组中W%、AT、VO2/HR等指标低于NRF组,但差异无统计学意义(P>0.05)。肺叶切除组患者中,术后RF组与NRF组心肺运动试验的所有指标相比,差异均无统计学意义(P>0.05)。结论心肺运动试验可以预测肺癌术后呼吸衰竭的发生,尤其适于全肺切除术后呼吸衰竭的预测,具有重要的临床意义。Objective To explore the clinical value of cardiopulmonary exercise test in predicting postoperative respiratory failure of patients with lung cancer. Methods 302 cases of patients with confirmed primary lung cancer and undergone resection operation in our hospital from June 2013 to March 2014 were selected and divided into pneumonectomy group（40 cases） and lobectomy group（262 cases）according to different surgery method. Patients were also divided into respiratory failure（RF） group and non-respiratory failure（NRF） group according to whether occurring postoperative respiratory failure. All patients were given cardiopulmonary exercise test by load progressive training before operations. The indicators at the termination of load training were recorded, and the results of RF group and NRF group were analyzed statistically. Results In patients with pneumonectomy, the VE, BF, VO2/kg, VO2%P, MET of cardiopulmonary exercise test of RF group were lower than those of NRF group, the difference was statistical（P〈0.05）; the W%, AT, VO2/HR of RF group were lower than those of NRF group, but the difference was not statistical（P〉0.05）. In patients with lobectomy, the indicators of cardiopulmonary exercise test of RF group and NRF group had no statistical difference（P〈0.05）. Conclusions Cardiopulmonary exercise test can predict the occurrence of postoperative respiratory failure after lung cancer resection, which is especially suitable for the prediction of respiratory failure and has important clinical significance.

关 键 词：心肺运动试验 肺癌 肺癌切除术 

分 类 号：R734.2[医药卫生—肿瘤]