Arruda Karine Aparecida, Cataneo Daniele Cristina, Cataneo Antonio José Maria
Postgraduate Program in General Basis of Surgery. Botucatu School of Medicine, UNESP, Botucatu-SP, Brazil.
Acta Cir Bras. 2013 Jun;28(6):458-66. doi: 10.1590/s0102-86502013000600010.
To investigate if tests used in the preoperative period of upper abdominal or thoracic surgeries are able to differentiate the patients that presented cardiopulmonary postoperative complications.
Seventy eight patients, 30 submitted to upper abdominal surgery and 48 to thoracic surgery were evaluated. Spirometry, respirometry, manovacuometry, six-minute walk test and stair-climbing test were performed. Complications from immediate postoperative to discharge from hospital were registered.
The postoperative complications rate was 17% in upper abdominal surgery and 10% in thoracic surgery. In the univariate regression, the only variable that kept the correlation with postoperative complications in the upper abdominal surgery was maximal expiratory pressure. In thoracic surgery, the maximal voluntary ventilation, six-minute walk test and time in stair-climbing test presented correlation with postoperative complications. After multiple regression only stair-climbing test continued as an important risk predictor in thoracic surgery.
The respiratory pressure could differentiate patients with complications in upper abdominal surgery, whereas in thoracic surgery, only spirometric values and exercise tests could differentiate them.
探讨在上腹部或胸部手术术前阶段所采用的检查能否区分出出现心肺术后并发症的患者。
对78例患者进行了评估，其中30例行上腹部手术，48例行胸部手术。进行了肺活量测定、呼吸测定、压力容积测定、6分钟步行试验和爬楼梯试验。记录了术后即刻至出院期间的并发症情况。
上腹部手术的术后并发症发生率为17%，胸部手术为10%。在单因素回归分析中，在上腹部手术中唯一与术后并发症保持相关性的变量是最大呼气压力。在胸部手术中，最大自主通气量、6分钟步行试验和爬楼梯试验时间与术后并发症相关。多因素回归分析后，仅爬楼梯试验在胸部手术中仍作为重要的风险预测指标。
呼吸压力可区分上腹部手术中有并发症的患者，而在胸部手术中，只有肺活量测定值和运动试验能够区分这些患者。
