肺癌术后肺复张形态与肺功能相关性及其影响因素的研究  

Correlation between lung re-expansion and pulmonary function and its influencing factors after lung cancer operation

作　　者：李新平[1] 陈艺[1,2] 刘霜纯 曾斌 张鸣生[1] Li Xinping;Chen Yi;Liu Shuangchun;Zeng Bin;Zhang Mingsheng(Department of Physical Medicine and Rehabilitation,Guangdong Geriatric Institute,Guangdong Academy of Medical Sciences&Guangdong Provincial People’s Hospital,Guangzhou 510080,China;Shenzhen Children’s Hospital,Shenzhen 518038,China;HeXian Memorial Affiliated Hospital,Guangzhou 511400,China)

机构地区：[1]广东省人民医院(广东省医学科学院)广东省老年医学研究所,广州510080 [2]深圳市儿童医院,深圳518038 [3]广州市番禺区妇幼保健院(何贤纪念医院),广州511400

出　　处：《中国临床解剖学杂志》2022年第5期610-614,共5页Chinese Journal of Clinical Anatomy

基　　金：国家自然科学基金(No.81972142,No.81871857)。

摘　　要：目的用定量CT测量肺解剖容积联合肺功能检测分析肺复张形态和肺功能相关性及其影响因素。方法本试验是单中心回顾性研究。纳入符合标准的肺部术后患者,分别在术前和术后3个月使用定量CT计算肺解剖容积,同时测量肺功能指标包括FVC、FEV_(1)和FEV_(1)/FVC。然后分析肺容积与肺功能的相关性;根据肺复张指标,将患者分为非肺膨胀组和肺过度膨胀组,比较两组术前、术后肺容积变化和肺功能差异。结果共纳入40例患者,手术导致肺功能和肺容积都降低,其术前FVC(r=0.36,P=0.037)、FEV_(1)(r=0.35,P=0.041)与肺容积呈正相关,术后3个月的FVC、FEV_(1)与肺容积无显著相关(P>0.05)。与非肺膨胀组相比较,肺过度膨胀组患者术前FEV_(1)/FVC更低,且术后3月患者FEV_(1)/FVC改善约5%;单因素分析表明个人吸烟史在肺过度膨胀组中更常见(P=0.045)。结论定量CT测量肺容积改变结合肺功能检查可用于早期识别术后肺过度膨胀形态,而吸烟史是肺肿瘤术后患者发生余肺过度膨胀的预测因素。Objective To analyze lung re-expansion and pulmonary function and their influencing factors by using quantitative CT and a spirometer.Methods A single-center retrospective study including post-operation patients with lung cancer was conducted.Quantitative CT was used to calculate the lung volume before operation and 3 months after operation.Respiratory function indicators including FVC,FEV_(1) and FEV_(1)/FVC were estimated by a spirometer.The correlation between lung volume and pulmonary function was analyzed.According to the pulmonary expansion indicator,the patients were divided into a nondistention group and hyperdistention group.The changes of lung volume and pulmonary function before and after operation were compared.Results A total of 40 patients were included in this study.Both lung volume and pulmonary function decreased after operation.The preoperative FVC(r=0.36,P=0.037)and FEV_(1)(r=0.35,P=0.041)were positively correlated with lung volume,and there was no significant correlation between FVC,FEV_(1) and lung volume at 3 months after operation(P>0.05).Compared with the non-distension group,the preoperative FEV_(1)/FVC of patients in the hyperdistention group was lower,and the FEV_(1)/FVC improved by about 5%at 3 months after operation.Univariate analysis revealed that smoking history was more common in the hyperdistention group(P=0.045).Conclusions Quantitative CT measurements combined with pulmonary function tests can be used to identify early postoperative lung hyperdistention morphology.Smoking history is a predictor of postoperative hyperdistention in patients with lung cancer.

关 键 词：定量CT 肺容积 肺功能 肺扩张 因素 

分 类 号：R323[医药卫生—人体解剖和组织胚胎学]