胸腔镜肺叶切除术后肺容积减少与患者肺功能丢失的相关性分析  

Correlation Analysis of the Lung Volume Reduction and the Lung Function Loss after the Thoracoscopic Lobectomy

作　　者：翟振州 赵军[1] 李畅[1] 丁成[1] 徐春[1] Zhenzhou ZHAI;Jun ZHAO;Chang LI;Cheng DING;Chun XU(Department of Thoracic Surgery,First Affiliated Hospital of Suzhou University,Suzhou 215006,China;Department of Neurosurgery,Tongren Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200336,China)

机构地区：[1]苏州大学附属第一医院胸外科,苏州215006 [2]上海交通大学医学院附属同仁医院急诊科,上海200336

出　　处：《中国肺癌杂志》2022年第1期21-25,共5页Chinese Journal of Lung Cancer

摘　　要：背景与目的探讨不同部位的肺叶切除术后患者肺容积减少与患者肺功能损害程度的相关性。方法本研究共纳入苏州大学附属第一医院2019年1月-2020年7月行胸腔镜肺叶切除术的131例患者(包括左肺上叶,左肺下叶,右肺上叶,右肺中叶,右肺下叶切除术;其中男性72例,女性59例)。为了比较患者术后肺功能与术前肺功能的差异,分别于术前7天和术后3个月、6个月及1年记录患者的肺功能测量值。采用1秒用力呼气量(forced expiratory volume in 1second,FEV_(1))作为肺功能变化的主要评估参数。采用Mimics Research 19.0软件计算出患者的原始肺容积,各阶段存留的肺容积。分析患者肺容积在上述时间节点与患者肺功能变化的相关性。结果术后患者FEV1较术前降低,下降程度与肺叶的切除体积呈正相关(其中左下肺下降较为明显)。值得注意的是,患者的肺功能降低程度在术后3个月、6个月与1年的差异无统计学意义。结论肺叶切除术后肺组织的容积减少是患者肺功能减少的主要原因,以左肺下叶表现为著,最早可选定术后3个月作为肺叶切除患者残留肺功能的评估节点。Background and objective To investigate the correlation between the reduction of lung volume and the degree of lung function damage after lobectomy.Methods A total of 131 patients(72 males and 59 females)who underwent thoracoscopic lobectomy in the First Affiliated Hospital of Suzhou University from January 2019 to July 2020(including thoracoscopic resection of left upper lobe,left lower lobe,right upper lobe,right middle lobe and right lower lobe).In order to compare the difference between postoperative pulmonary function and preoperative pulmonary function,the pulmonary function measurements were recorded at 7 days before operation,and 3 months,6 months and 1 year after operation.Forced expiratory volume in 1 second(FEV_(1))was used as the main evaluation parameter of pulmonary function.The original lung volume and the remaining lung volume at each stage were calculated by Mimics Research 19.0 software.The correlation between lung volume and lung function was analyzed.Results FEV_(1)in postoperative patients was lower than that before operation,and the degree of decline was positively correlated with the resection volume of lung lobes(the maximum value was shown in the left lower lobe group).Significantly,there was no significant difference in the degree of pulmonary function reduction between 3 months,6 months and 1 year after operation.Conclusion The decrease of lung tissue volume after lobectomy is the main reason for the decrease of lung function,especially in the left lower lobe.And 3 months after lobectomy can be selected as the evaluation node of residual lung function.

关 键 词：胸腔镜肺叶切除术 肺容积 肺功能 

分 类 号：R734.2[医药卫生—肿瘤]