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与大肺切除术后运动能力早期恢复相关的因素。

Factors related to an early restoration of exercise capacity after major lung resection.

机构信息

Department of Surgery, National Hospital Organization Omuta National Hospital, 1044-1 Tachibana, Ohmuta, Fukuoka, 837-0911, Japan.

出版信息

Surg Today. 2011 Sep;41(9):1228-33. doi: 10.1007/s00595-010-4441-7. Epub 2011 Aug 26.

Abstract

PURPOSE

We attempted to identify the factors related to an early restoration of the exercise capacity after lung resection.

METHODS

Major lung resection was performed in 164 patients. Exercise testing and spirometry were performed before surgery, and 2 weeks and 1 month afterward. During exercise, the maximum oxygen uptake per minute per m(2) of body surface area (VO(2)max/m(2)) was measured. The percent change of VO(2)max/m(2) at 2 weeks and 1 month after surgery was calculated by setting the preoperative VO(2)max/m(2) value as 100%. Patients were then assigned to the early restoration group or late restoration group according to their VO(2)max/m(2) measured 2 weeks after surgery. Preoperative cardiopulmonary function, as well as various preoperative and intraoperative factors were compared between the two groups.

RESULTS

At 2 weeks after surgery, the mean VO(2)max/m(2) was 80.9% compared with that before surgery, and was 88.1% at 1 month. A multivariate analysis showed that the surgical method used (thoracotomy and mediastinal lymph node dissection) had a significant effect on the postoperative restoration of the VO(2)max/m(2).

CONCLUSION

An early restoration of exercise capacity after lung resection is possible in patients without mediastinal lymph node dissection and in those who have a small thoracotomy wound.

摘要

目的

我们试图确定与肺切除术后运动能力早期恢复相关的因素。

方法

对 164 例患者进行了肺切除术。在术前、术后 2 周和 1 个月进行运动试验和肺功能检查。在运动过程中,测量每平方米体表面积每分钟最大耗氧量(VO2max/m2)。术后 2 周和 1 个月时,将术前 VO2max/m2 值设定为 100%,计算 VO2max/m2 的变化百分比。根据术后 2 周时测量的 VO2max/m2 值,将患者分为早期恢复组和晚期恢复组。比较两组患者术前心肺功能以及各种术前和术中因素。

结果

术后 2 周时,平均 VO2max/m2 与术前相比为 80.9%,术后 1 个月时为 88.1%。多因素分析显示,所采用的手术方法(开胸和纵隔淋巴结清扫)对术后 VO2max/m2 的恢复有显著影响。

结论

对于未行纵隔淋巴结清扫术和采用小切口开胸术的患者,肺切除术后运动能力可早期恢复。

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