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[慢性阻塞性肺疾病对肺癌患者术后肺功能的影响及肺灌注扫描的预测价值]

[Influence of chronic obstructive pulmonary disease on postoperative lung function of lung cancer patients and predictive value of lung perfusion scan].

作者信息

Liao Wei, Ma Gang, Fang Yi, Wang Chun-Mei

机构信息

State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, P. R. China.

出版信息

Ai Zheng. 2009 Jun;28(6):642-6.

Abstract

BACKGROUND AND OBJECTIVE

Postoperative lung function is closely related to the prognosis of lung cancer patients after lobectomy. This study was to explore the influence of chronic obstructive pulmonary disease (COPD) on postoperative lung function in patients undergoing lobectomy for non-small cell lung cancer (NSCLC), and to assess the predictive value of lung perfusion scan for lung cancer patients with COPD before operation.

METHODS

Clinical data of 65 NSCLC patients who underwent lobectomy were analyzed. Of the 65 patients, 25 had COPD (COPD group) and 40 had normal lung function (control group). The change of forced expiratory volume in 1st second (FEV1) after lobectomy and deference between postoperative FEV1 and preoperative predictive postoperative (ppo) FEV1 were compared between the two groups. For ten patients with COPD who had undergone lung perfusion scan before operation, ppo'FEV1 by lung perfusion scan and ppoFEV1 by equation were compared.

RESULTS

The mean percent loss of FEV1 was less in COPD group than in control group (8.98% vs. 22.47%, P<0.05). The value of postoperative FEV1 minus ppoFEV1 and the ratio of postoperative FEV1 to ppoFEV1 were significantly higher in COPD group than in control group (6.90 vs. 0.83, P<0.05; 1.14 vs. 1.01, P<0.05). For the ten patients undergone lung perfusion scan, the mean value of ppo'FEV1 minus ppoFEV1 was 4.04%, with a 95% confidence interval of 3.01%-5.07%.

CONCLUSIONS

The mean loss of lung function after lobectomy is less in lung cancer patients with COPD than in patients with normal lung function. Lung perfusion scan before operation may help to predict postoperative lung function of lung cancer patients with COPD.

摘要

背景与目的

术后肺功能与肺癌患者肺叶切除术后的预后密切相关。本研究旨在探讨慢性阻塞性肺疾病(COPD)对非小细胞肺癌(NSCLC)患者肺叶切除术后肺功能的影响,并评估肺灌注扫描对术前COPD肺癌患者肺功能的预测价值。

方法

分析65例行肺叶切除术的NSCLC患者的临床资料。65例患者中,25例患有COPD(COPD组),40例肺功能正常(对照组)。比较两组肺叶切除术后第1秒用力呼气量(FEV1)的变化以及术后FEV1与术前预测术后(ppo)FEV1的差值。对10例术前进行肺灌注扫描的COPD患者,比较肺灌注扫描得到的ppo'FEV1与公式计算得到的ppoFEV1。

结果

COPD组FEV1的平均损失百分比低于对照组(8.98%对22.47%,P<0.05)。COPD组术后FEV1减去ppoFEV1的值以及术后FEV1与ppoFEV1的比值显著高于对照组(6.90对0.83,P<0.05;1.14对1.01,P<0.05)。对于10例进行肺灌注扫描的患者,ppo'FEV1减去ppoFEV1的平均值为4.04%,95%置信区间为3.01%-5.07%。

结论

COPD肺癌患者肺叶切除术后肺功能的平均损失低于肺功能正常的患者。术前肺灌注扫描可能有助于预测COPD肺癌患者的术后肺功能。

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