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术前肺功能测定预测胸外科手术患者术后并发症

Preoperative spirometry to predict postoperative complications in thoracic surgery patients.

作者信息

Phunmanee A, Tuntisirin C, Zaeoue U

机构信息

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.

出版信息

J Med Assoc Thai. 2000 Oct;83(10):1253-9.

Abstract

UNLABELLED

Spirometry is a simple and basic test that can provide more information about pulmonary function. Many thoracic surgeons do a spirometry test to assess the pulmonary status of their patients before surgery.

OBJECTIVE

To determine if preoperative spirometry can predict postoperative complications following thoracic surgery.

DESIGN

Retrospective case control study.

SETTING

Srinagarind Hospital Medical School, Khon Kaen University, Khon Kaen Thailand.

PARTICIPANTS

Adult patients who had spirometry before thoracic surgery.

MEASUREMENT AND RESULTS

From 1995 to 1998, we reviewed thoracic surgery patients who had spirometry testing before thoracic surgery. Fifty-six patients were enrolled in our study. Postoperative complications of these patients were determined by a systemic extraction of medical record data. The postoperative complications were classified into two groups, respiratory and non-respiratory complications. Eighteen patients experienced at least one respiratory and other complications. There was a sixfold or greater increase in non-respiratory complications (cardiac arrhythmia, congestive heart failure, prolonged hospital stay, upper gastrointestinal bleeding and wound infection), which were associated with moderate and severe impairment of FEV1 and FVC (< 66% predicted) (P < 0.05). There was a thirty percent increase in non-respiratory complications, which were associated with FEV1 < 2 liters (p < 0.05), FEV1 or FVC less than 70 per cent of predicted value (p < 0.05). No spirometric values were a good predictor of respiratory complications.

CONCLUSION

Preoperative spirometry levels in patients requiring thoracic surgery of FEV1 < 2 liters, FEV1 or FVC < 70 per cent of predicted value was associated with postoperative complications, especially non-respiratory complications.

摘要

未标注

肺量测定法是一种简单的基础测试,能够提供更多关于肺功能的信息。许多胸外科医生在手术前会进行肺量测定测试,以评估患者的肺部状况。

目的

确定术前肺量测定法能否预测胸外科手术后的并发症。

设计

回顾性病例对照研究。

地点

泰国孔敬府孔敬大学诗里拉吉医院医学院。

参与者

胸外科手术前进行过肺量测定的成年患者。

测量与结果

1995年至1998年,我们回顾了胸外科手术前进行过肺量测定测试的患者。56名患者纳入我们的研究。通过系统提取病历数据确定这些患者的术后并发症。术后并发症分为两组,即呼吸并发症和非呼吸并发症。18名患者至少经历了一种呼吸并发症和其他并发症。非呼吸并发症(心律失常、充血性心力衰竭、住院时间延长、上消化道出血和伤口感染)增加了六倍或更多,这与FEV1和FVC的中度和重度损害(<预测值的66%)相关(P<0.05)。非呼吸并发症增加了30%,这与FEV1<2升(p<0.05)、FEV1或FVC低于预测值的70%(p<0.05)相关。没有肺量测定值能很好地预测呼吸并发症。

结论

需要进行胸外科手术的患者术前肺量测定水平FEV1<2升、FEV1或FVC<预测值的70%与术后并发症相关,尤其是非呼吸并发症。

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