Toyoizumi S, Usui S, Sakamoto A, Takaishi S, Yamazaki K, Kawamura I, Okuyama K, Onoda S, Isono K
Second Department of Surgery, School of Medicine, University of Chiba, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1990 Feb;38(2):215-21.
In 91 patients undergoing resection and reconstruction of the esophagus for esophageal cancer, risk factors for postoperative pulmonary complications were studied. In order to investigate these factors, multivariate statistical analysis was applied. The incidence of postoperative pulmonary complications was significantly higher in patients over 70 years of age who had poor renal function (PSP15' less than 25%) and had prolonged thoracotomy time (greater than 3 h) by Student's t test. In preoperative pulmonary functions, obstructive respiratory dysfunction (MMF, FEV1.0) correlated well with postoperative pulmonary complications. The analysis of each factor was, however, not enough to predict the risk of pulmonary complications following operation. Meanwhile, risk score (= 2.0 (age) + 1.0 (FVC) + 0.7 (MMF) + 1.5 (PSP15') + 1.8 (thoracotomy time) + 1.7 (postoperative RI] was obtained by multivariate statistical analysis. High incidence (greater than 80%) of pulmonary complications was observed in patients with risk score more than 5.0. It is suggested that using this risk score will be helpful for postoperative pulmonary care.
对91例因食管癌接受食管切除重建术的患者，研究了术后肺部并发症的危险因素。为研究这些因素，应用了多变量统计分析。经Student's t检验，70岁以上、肾功能差（酚红排泄率15'小于25%）且开胸时间延长（大于3小时）的患者术后肺部并发症发生率显著更高。在术前肺功能方面，阻塞性呼吸功能障碍（最大呼气中期流速、第一秒用力呼气容积）与术后肺部并发症密切相关。然而，对每个因素的分析不足以预测术后肺部并发症的风险。同时，通过多变量统计分析得出风险评分（=2.0（年龄）+1.0（用力肺活量）+0.7（最大呼气中期流速）+1.5（酚红排泄率15'）+1.8（开胸时间）+1.7（术后肌酸酐指数））。风险评分超过5.0的患者肺部并发症发生率高（大于80%）。提示使用该风险评分将有助于术后肺部护理。
