Santini M, Fiorello A, Vicidomini G, Di Crescenzo V G, Laperuta P
Department of Thoracic Surgery Unit, Second University of Naples, Naples, Italy.
Thorac Cardiovasc Surg. 2007 Sep;55(6):391-4. doi: 10.1055/s-2007-965326.
The purpose of our study was to determine whether the assessment of the diffusing capacity of the lung for carbon monoxide (DL (CO)), together with the forced expiratory volume in 1 second (FEV (1)), could improve the selection of surgical patients.
The data of 76 patients undergoing major lung resection (pnemonectomy, bilobectomy or lobectomy) for non-small cell lung cancer were retrospectively studied. All patients were reviewed for age, sex, preexisting medical conditions, operative, and pathological findings and postoperative outcome.
Univariate and multivariable logistic regression analysis showed that ppoFEV (1) and ppoDL (CO) were the only statistically significant predictors of pulmonary complications. In the group of patients with marginal ppoFEV (1) (between 30 - 40 %), ppoDL (CO) predicted pulmonary morbidity with a better accuracy ( P < 0.005) than ppoFEV (1) ( P > 0.05). Multiple regression analysis showed that pneumonectomy was the only statistical factor correlated with mortality ( P < 0.05).
Our experience seems to suggest that ppoDL (CO) is a strong predictor of pulmonary complications after major lung resection, allowing a better surgical selection of the patients with compromised respiratory function.
我们研究的目的是确定一氧化碳弥散功能(DL(CO))评估与一秒用力呼气容积(FEV(1))是否能改善手术患者的选择。
回顾性研究76例因非小细胞肺癌接受肺大部切除术(全肺切除术、双叶切除术或肺叶切除术)的患者数据。对所有患者的年龄、性别、既往病史、手术及病理结果和术后转归进行评估。
单因素和多因素逻辑回归分析显示,术后一秒用力呼气容积(ppoFEV(1))和术后一氧化碳弥散功能(ppoDL(CO))是肺部并发症唯一具有统计学意义的预测指标。在术后一秒用力呼气容积处于临界值(30%-40%)的患者组中,ppoDL(CO)预测肺部发病率的准确性(P<0.005)优于ppoFEV(1)(P>0.05)。多元回归分析显示,全肺切除术是与死亡率相关的唯一统计学因素(P<0.05)。
我们的经验似乎表明,ppoDL(CO)是肺大部切除术后肺部并发症的有力预测指标,有助于更好地筛选呼吸功能受损的患者进行手术。