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术后并发症并不影响有风险的肺癌患者肺切除术后早期肺功能恢复模式。

Postoperative complications do not influence the pattern of early lung function recovery after lung resection for lung cancer in patients at risk.

作者信息

Ercegovac Maja, Subotic Dragan, Zugic Vladimir, Jakovic Radoslav, Moskovljevic Dejan, Bascarevic Slavisa, Mujovic Natasa

机构信息

Clinic for thoracic surgery, Clinical center of Serbia, University of Belgrade school of medicine, Visegradska 26, 11000 Belgrade, Serbia.

出版信息

J Cardiothorac Surg. 2014 May 19;9:92. doi: 10.1186/1749-8090-9-92.

Abstract

BACKGROUND

The pattern and factors influencing the lung function recovery in the first postoperative days are still not fully elucidated, especially in patients at increased risk.

METHODS

Prospective study on 60 patients at increased risk, who underwent a lung resection for primary lung cancer.

INCLUSION CRITERIA

complete resection and one or more known risk factors in form of COPD, cardiovascular disorders, advanced age or other comorbidities. Previous myocardial infarction, myocardial revascularization or stenting, cardiac rhythm disorders, arterial hypertension and myocardiopathy determined the increased cardiac risk. The severity of COPD was graded according to GOLD criteria. The trend of the postoperative lung function recovery was assessed by performing spirometry with a portable spirometer.

RESULTS

Cardiac comorbidity existed in 55%, mild and moderate COPD in 20% and 35% of patients respectively. Measured values of FVC% and FEV1% on postoperative days one, three and seven, showed continuous improvement, with significant difference between the days of measurement, especially between days three and seven. There was no difference in the trend of the lung function recovery between patients with and without postoperative complications. Whilst pO2 was decreasing during the first three days in a roughly parallel fashion in patients with respiratory, surgical complications and in patients without complications, a slight hypercapnia registered on the first postoperative day was gradually abolished in all groups except in patients with cardiac complications.

CONCLUSION

Extent of the lung resection and postoperative complications do not significantly influence the trend of the lung function recovery after lung resection for lung cancer.

摘要

背景

术后最初几天肺功能恢复的模式及影响因素仍未完全阐明,尤其是在高危患者中。

方法

对60例高危患者进行前瞻性研究,这些患者因原发性肺癌接受了肺切除术。

纳入标准

完全切除且存在一种或多种已知危险因素,形式为慢性阻塞性肺疾病(COPD)、心血管疾病、高龄或其他合并症。既往心肌梗死、心肌血运重建或支架置入、心律失常、动脉高血压和心肌病决定了心脏风险增加。COPD的严重程度根据GOLD标准分级。通过使用便携式肺量计进行肺量测定来评估术后肺功能恢复的趋势。

结果

55%的患者存在心脏合并症,20%和35%的患者分别存在轻度和中度COPD。术后第1天、第3天和第7天的用力肺活量(FVC)%和第1秒用力呼气容积(FEV1)%测量值呈持续改善,测量日之间存在显著差异,尤其是第3天和第7天之间。有术后并发症和无术后并发症的患者在肺功能恢复趋势上无差异。虽然在有呼吸、手术并发症的患者和无并发症的患者中,前三天pO2大致呈平行下降趋势,但除有心脏并发症的患者外,所有组在术后第1天记录到的轻度高碳酸血症逐渐消失。

结论

肺癌肺切除术后肺功能恢复的趋势不受肺切除范围和术后并发症的显著影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe5b/4066321/4e6eb5259df1/1749-8090-9-92-1.jpg

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