呼气峰值流量对食管癌微创手术术后肺部感染的预测价值  

Value of peak expiratory flow in predicting pulmonary infection after minimally invasive surgery for esophageal cancer

作　　者：樊怿辉[1] 施民新[1] 陈赛华[1] 居冠军[1] 许峰[1] 肖婷[1] FAN Yi-hui;SHI Min-xin;CHEN Sai-hua;JU Guan-jun;XU Feng;XIAO Ting(Department of Thoracic Surgery,Nantong Tumor Hospital,Nantong,Jiangsu 226361,China)

机构地区：[1]南通市肿瘤医院胸外科

出　　处：《中国临床研究》2019年第8期1052-1055,共4页Chinese Journal of Clinical Research

基　　金：江苏省南通市青年医学人才科研基金项目(WQ2016062)~~

摘　　要：目的探讨呼气峰值流量(PEF)对食管癌微创手术后发生肺部感染的预测价值。方法回顾性分析2016年5月至2018年4月进行胸腹腔镜食管癌根治术治疗的140例患者的临床资料。根据术后是否发生肺部感染分为感染组26例和非感染组(对照组)114例。对两组患者手术时间、手术出血量、清扫淋巴结数量、麻醉时间、留置胸管时间和住院时间进行比较;比较两组患者术前肺功能指标[肺活量、用力肺活量、最大通气量、一秒用力呼气容积(FEV1)、呼气峰值流量(PEF)及一氧化碳弥散量(DLCO)]。对术后肺部感染的影响因子进行多因素Logistic回归分析。结果两组患者手术时间、手术出血量、清扫淋巴结数量、麻醉时间、留置胸管时间和住院时间比较均无统计学差异(P>0.05)。感染组FEV1和PEF低于对照组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,PEF是食管癌患者术后发生感染的独立影响因素(P<0.05)。结论PEF与食管癌患者微创手术后发生肺部感染显著相关,可作为预测术后发生肺部感染的指标。Objective To investigate the value of peak expiratory flow (PEF) in predicting pulmonary infection after minimally invasive surgery for esophageal cancer.Methods A retrospective analysis was performed on the clinical data of 140 patients receiving thoracoscopic and laparoscopic radical esophagectomy for esophageal cancer from May 2016 to April 2018.According to whether there were pulmonary infection after operation,the patients were divided into infection group (n = 26) and non-infection group (n = 114).The operation time,bleeding volume,lymph node clearance,anesthesia time, chest tube indwelling time and hospitalization time were compared between two groups.The preoperative pulmonary function indexes,including vital capacity,forced vital capacity,maximum ventilation volume,forced expiratory volume in one second (FEV1 ),PEF and carbon monoxide diffusing capacity(DLCO) were compared between two groups.Multivariate logistic regression analysis was performed for influencing factors of postoperative pulmonary infection.Results There were no significant differences in operation time,bleeding volume,number of lymph nodes dissection,anesthesia time,indwelling time of thoracic tube and hospital stay between two groups (P > 0.05).The FEV1 and PEF in infection group were lower than those in ron-infection group (P < 0.05 ).Multivariate regression analysis showed that PEF was an independent influencing factor of infection after esophageal cancer surgery (P < 0.05).Conclusion PEF is significantly correlated with pulmonary infection after minimally invasive surgery in patients with esophageal cancer and can be used as a predictor for postoperative pulmonary infection.

关 键 词：食管癌 胸腹腔镜食管癌根治术 呼气峰值流量 肺部感染 一秒用力呼气容积 

分 类 号：R735.1[医药卫生—肿瘤]