Kushibe Keiji, Kawaguchi Takeshi, Kimura Michitaka, Takahama Makoto, Tojo Takashi, Taniguchi Shigeki
Department of Thoracic and Cardiovascular Surgery, Nara Medical University School of Medicine, Kashihara, Nara, 634-8522, Japan.
Interact Cardiovasc Thorac Surg. 2009 May;8(5):529-33. doi: 10.1510/icvts.2008.196303. Epub 2009 Feb 6.
The aim of this retrospective study was to evaluate the influence of the site of lobectomy and the presence of chronic obstructive pulmonary disease (COPD) on pulmonary function at different postoperative periods. The patients were divided into groups of COPD and non-COPD patients, and the differences between observed and predicted postoperative values of pulmonary function at different evaluation times according to the resected lobe were assessed. The observed postoperative percentage change in FEV(1) (opo%DeltaFEV(1)) - predicted postoperative percentage change in FEV(1) (ppo%DeltaFEV(1)) one month and six months after right upper lobectomy or left upper lobectomy in COPD patients was of significantly higher positive value than in non-COPD patients. In non-COPD patients, opo%DeltaFEV(1) - ppo%DeltaFEV(1) one month and six months after surgery was of significantly higher negative value in those who had right upper lobectomy than in those who had right lower lobectomy or left lower lobectomy (P<0.05). COPD may strongly influence pulmonary function at early- and late-terms after upper lobectomy. In non-COPD patients, the site of lobectomy may strongly influence pulmonary function at early- and late-terms after surgery.
这项回顾性研究的目的是评估肺叶切除部位和慢性阻塞性肺疾病(COPD)的存在对不同术后时期肺功能的影响。将患者分为COPD患者组和非COPD患者组,并根据切除的肺叶评估不同评估时间观察到的和预测的术后肺功能值之间的差异。COPD患者右上叶或左上叶切除术后1个月和6个月观察到的术后第1秒用力呼气容积百分比变化(opo%ΔFEV(1))-预测的术后第1秒用力呼气容积百分比变化(ppo%ΔFEV(1))的正值显著高于非COPD患者。在非COPD患者中,术后1个月和6个月,接受右上叶切除术者的opo%ΔFEV(1)-ppo%ΔFEV(1)的负值显著高于接受右下叶切除术或左下叶切除术者(P<0.05)。COPD可能对上叶切除术后早期和晚期的肺功能有强烈影响。在非COPD患者中,肺叶切除部位可能对术后早期和晚期的肺功能有强烈影响。