难治性肺结核手术术前呼吸功能评估与术中、术后并发症的相关性  

Correlation between Preoperative Respiratory Function Assessment and Intraoperative and Postoperative Complications in Patients with Refractory Pulmonary Tuberculosis

作　　者：亢平 喻娟 徐芬兰 马丽 KANG Ping;YU Juan;XU Fenlan(Public Health Clinical Center of Chengdu,Chengdu City,Sichuan Province 610061)

机构地区：[1]四川省成都市公共卫生临床医疗中心,610061

出　　处：《医学理论与实践》2021年第13期2184-2186,共3页The Journal of Medical Theory and Practice

基　　金：成都市卫生和计划生育委员会科研课题(2015189)。

摘　　要：目的:探究难治性肺结核手术术前呼吸功能评估与术中、术后并发症的相关性。方法:选取2016年3月—2019年3月我院难治性肺结核患者80例,均行肺切除术,根据术前肺实质功能综合评估结果严重程度分为1组(n=28)、2组(n=27)、3组(n=25),对比三组术中与术后并发症、术后发热时间、术后抗生素应用时间、术后住ICU时间。按照是否发生并发症分为并发症组25例,未发生并发症组55例,对比两组肺实质功能差异,进行影响难治性肺结核患者术后并发症的多因素分析。结果:1组术中与术后并发症发生率低于2组、3组,术后发热时间、术后抗生素应用时间、术后住ICU时间短于2组、3组(P<0.05);并发症组FEV 1%、MVV%、VO_(2)/kg、VO_(2)%、AT、BF、6min步行试验距离低于未发生并发症组,PaCO_(2)高于未发生并发症者(P<0.05);FEV 1%、MVV%、VO_(2)/kg、VO_(2)%、AT、BF、6min步行试验距离为影响难治性肺结核患者术后并发症的保护因素,PaCO_(2)为影响难治性肺结核患者术后并发症的危险因素(P<0.05)。结论:难治性肺结核手术患者术前呼吸功能与术中、术后并发症相关,呼吸功能越好,并发症越少。Objective:To explore the correlation between preoperative respiratory function and intraoperative and postoperative complications in patients with refractory pulmonary tuberculosis.Methods:From March 2016 to March 2019,80 patients with refractory pulmonary tuberculosis underwent pneumonectomy.According to the comprehensive evaluation of pulmonary parenchymal function,they were divided into Group 1(n=28),Group 2(n=27),Group 3(n=25).The postoperative complications,postoperative fever time,postoperative antibiotic application time and ICU stay time of the 3 groups were compared.According to the occurrence of complications,25 cases were divided into the complication group and 55 cases in the uncomplication group.The differences of pulmonary parenchymal function between the 2 groups were compared.Results:The incidence of intraoperative and postoperative complications in Group 1 was lower than that in Group 2 and Group 3 postoperative fever time,postoperative antibiotic application time,postoperative ICU stay is shorter than in Group 2 and Group 3(P<0.05)The distance of FEV 1%,MVV%,VO_(2)/kg,VO_(2)%,AT,BF,6-minute walking test in the patients with complications was lower than that in the patients without complications,and PaCO_(2) was higher than that in the patients without complications(P<0.05).FEV 1%,MVV%,VO_(2)/kg,VO_(2)%,AT,BF,6-minute walking distance were the protective factors for postoperative complications in patients with refractory pulmonary tuberculosis,and PaCO_(2) was the risk factor for postoperative complications in patients with refractory pulmonary tuberculosis(P<0.05).Conclusion:Preoperative respiratory function is related to intraoperative and postoperative complications in patients with refractory pulmonary tuberculosis.The better respiratory function,the fewer complications.

关 键 词：难治性肺结核 肺切除术 并发症 呼吸功能 心肺功能运动试验 6min步行试验 

分 类 号：R521[医药卫生—内科学]