呼气流量峰值与食管癌患者术后肺部感染的相关性及预测价值分析  

The correlation analysis and predictive value of peak expiratory flow on pulmonary infection after esophageal carcinoma operation

作　　者：董伟[1] 魏然[2] 吴志南 杜贾军[1] 孟龙[1] 

机构地区：[1]山东大学附属省立医院胸外微创肺移植科,济南,250021 [2]浙江省人民医院超声科

出　　处：《中华胸心血管外科杂志》2017年第9期557-560,共4页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：山东省自然科学基金（ZR2014HQ073）,山东省重点研发计划（2015GSF118109）

摘　　要：目的 研究食管癌患者围手术期包括肺功能在内的多种相关因素与术后肺部感染之间的相关性,以及肺功能指标PEF作为其预测因素的预测效能.方法 纳入连续收治的两组食管癌患者,第1组321例分为术后肺部感染组（30例）和对照组（291例）,研究围手术期多种相关因素与术后肺部感染的相关性并确定具有预测价值的指标;第2组50例以PEF为变量构建预测食管癌术后肺部感染模型,验证预测模型的准确性与灵敏度.结果 第1组患者的研究结果显示,术前糖尿病史、既往大手术史、肺功能指标中的第1 s用力呼气量（FEV1）及呼气流量峰值（PEF）在术后肺部感染组与对照组之间存在显著差异,经FDR校正仅FEV1和PEF差异仍有统计学意义,logistic多因素分析显示PEF是食管癌术后肺部感染的独立预测因素.第2组结果显示PEF作为预测指标具有较好的特异性和敏感性.结论 PEF与食管癌患者术后肺部感染的发生具有显著相关性,并且PEF可作为术后肺部感染的有效预测指标.Objective To investigate the correlation between perioperative risk factors including pulmonary fuction indexs and the occurance of postoperative pneumonia in esophageal carcinoma patients,and the prediction efficiency of Peak Expiratory Flow （PEF）.Methods Two groups of consecutive esophageal carcinoma patients were included,321 patients in group 1 were devided into postoperative pneumonia group （n =30） and control group （n =291） to screen any relavent risk factom on postoperative pneumonia;group 2 （n =50） was to verify the accurancy and sensitivity of the predictive index.Results he results from group 1 showed that preoperative history of diabetes,previous surgery history,lung function index FEV1 and PEF in the presence of significant differences between the postoperative pneumonia group and the control group,after FDR correction FEV1 and PEF still have statistical significance.Multivariate logistic analysis showed that PEF was an independent prognostic factor of lung infection after esophageal cancer surgery.We build a predictive model with PEF as a variable index of lung infection after esophageal cancer surgery in group 2,the results showed that PEF as a predictor of pulmonary infection has good specificity and sensitivity.Conclusion PEF has a significant correlation with postoperative pulmonary infection in patients with esophageal cancer,and PEF can be used as an effective predictor of postoperative pulmonary infection.

关 键 词：食管肿瘤 肺部感染 呼气流量峰值 

分 类 号：R735.1[医药卫生—肿瘤]