肺气肿指数预测Ⅰ~Ⅱa期肺癌患者肺叶切除术后呼吸系统并发症的效能研究  

Efficiency of emphysema index in predicting respiratory system complications after lobectomy in patients with stageⅠ-Ⅱa lung cancer

作　　者：党荣广 韩鲁军[1] 杨晔 张燕[1] 董英辉[1] DANG Rongguang;HAN Lujun;YANG Ye;ZHANG Yan;DONG Yinghui(Department of Oncology,Shijiazhuang Municipal First Hospital,Shijiazhuang,Hebei 050000,China)

机构地区：[1]河北省石家庄市第一医院肿瘤科,050000

出　　处：《重庆医学》2022年第14期2405-2409,共5页Chongqing medicine

基　　金：河北省医学科学研究计划项目(20191462)。

摘　　要：目的探讨肺气肿指数(EI)预测Ⅰ~Ⅱa期肺癌患者肺叶切除术后呼吸系统并发症的效能。方法回顾性分析2018年10月至2021年5月该院收治的115例行肺叶切除术的Ⅰ~Ⅱa期肺癌患者(A组)的资料,选取同期体检的103例健康者为对照(B组)。对比两组EI、肺功能及A组不同临床分期EI,分析A组呼吸系统并发症发生率(包括肺部感染、肺不张、胸腔积液、低氧血症、肺动脉栓塞和呼吸衰竭等);分析术前EI与Ⅰ~Ⅱa期肺癌患者肺叶切除术后发生呼吸系统并发症的关系和其对后者的预测效能。结果两组EI比较差异无统计学意义(P>0.05),A组Ⅰa期、Ⅰb期、Ⅱa期患者EI比较差异无统计学意义(P>0.05)。随访期间,A组呼吸系统并发症发生率13.04%。A组用力肺活量(FVC)、第1秒用力呼气量(FEV_(1))、第1秒用力呼气量实测值占预测值的比值(FEV_(1)%)均低于B组(P<0.05),A组EI与FVC、FEV_(1)、FEV_(1)%均呈负相关(r=-0.726、-0.709、-0.684,P=0.019、0.028、0.042)。A组有呼吸系统并发症患者术前EI高于无呼吸系统并发症患者(P<0.05)。合并糖尿病、术前中度肺通气障碍、吸烟史、术前EI高均是A组术后有呼吸系统并发症的独立危险因素(P<0.05)。EI预测Ⅰ~Ⅱa期肺癌患者肺叶切除术后发生呼吸系统并发症的最佳截断点为10.12%,灵敏度、特异度和曲线下面积(AUC)分别为80.00%、83.00%和0.843。结论EI在肺癌患者肺叶切除术后呼吸系统并发症的预测中可能具有重要价值。Objective To explore the efficiency of the emphysema index(EI)in predicting the respiratory complications after lobectomy in the patients with stageⅠ-Ⅱa lung cancer.Methods The data of 115 patients with stageⅠ-Ⅱa lung cancer treated by lobectomy(group A)in this hospital from October 2018 to May 2021 were retrospectively analyzed and 103 healthy persons undergoing the physical examination in this hospital during the same period were selected as the controls(group B).EI and lung function were compared between the two groups.EI and the incidence rates of respiratory system complications(including lung infection,pulmonary atelectasis,pleural effusion,hyoxemia,pulmonary arterial embolism,respiratory failure,etc.)were compared among different clinical stages in the group A.The relationships between preoperative EI and respiratory system complications occurrence after lobectomy in the patients with stageⅠ-Ⅱa lung cancer and the predictive efficiency for the latter were analyzed.Results There was no statistically significant difference in preoperative EI between the two groups(P>0.05).There was no statistically significant difference in preoperative EI among the stageⅠa,Ⅰb andⅡa of the group A(P>0.05).During the follow-up,the incidence rate of respiratory system complications in the group A was 13.04%.The ratio value of FVC,FEV_(1) and FEV_(1)%to the predictive measure values in the group A were lower than that in the group B(P<0.05).EI inthe group A was negatively correlated with the predictive values of FVC,FEV_(1) and FEV_(1)%(r=-0.726,-0.709,-0.684,P=0.019,0.028,0.042).The preoperative EI values in the patients with respiratory system complications of the group A was higher than that of the patients without respiratory system complications(P<0.05).Complicating diabetes mellitus,preoperative moderate pulmonary ventilation disorder,smoking history and preoperative EI all were the independent risk factors for respiratory system complications of the group A(P<0.05).The best cut-off point of EI for predi

关 键 词：肺气肿指数 肺叶切除术 呼吸系统 并发症 

分 类 号：R734.2[医药卫生—肿瘤]