Kim Hyun Koo, Lee Yoo Jin, Han Kook Nam, Choi Young Ho
Departments of Thoracic and Cardiovascular Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
Korea University College of Medicine, Seoul, Korea.
Respir Care. 2016 Mar;61(3):376-82. doi: 10.4187/respcare.04284. Epub 2015 Nov 24.
This study was conducted to measure the serial changes in pulmonary function over 12 months after lobectomy in subjects with lung cancer and to evaluate the actual recovery of pulmonary function in comparison with the predicted postoperative values.
Subjects who underwent lobectomy for primary lung cancer were included in this study. In the statistical analysis, we included data from 76 subjects (52 men and 24 women; mean age, 63.4 y) who completed perfusion scintigraphy 1 week before surgery and FEV1 and diffusion capacity of the lung for carbon monoxide (DLCO) assessments preoperatively and at 1, 6, and 12 months postoperatively.
The actual percent-of-predicted FEV1 1 month postoperatively was 77.9% of the preoperative value, which was almost equal to the predicted postoperative value, and significantly increased to 84.3% by 6 months and 84.2% at 12 months. The actual percent-of-predicted DLCO 1 month postoperatively was 81.8% of the preoperative value, which was similar to the predicted postoperative value, and also significantly increased to 91.3% at 6 months and 96.5% at 12 months. However, the actual pulmonary function test results at 1 y in subjects with COPD or in those who underwent thoracotomy or received adjuvant chemotherapy were not different from the predicted postoperative values.
Actual pulmonary function compared with predicted postoperative values improved over time over 1 y after lobectomy. However, this improvement was not observed in subjects with COPD or in those who underwent thoracotomy or received postoperative adjuvant chemotherapy.
本研究旨在测量肺癌患者肺叶切除术后12个月内肺功能的系列变化,并与术后预测值相比较,评估肺功能的实际恢复情况。
本研究纳入了因原发性肺癌接受肺叶切除术的患者。在统计分析中,我们纳入了76名患者(52名男性和24名女性;平均年龄63.4岁)的数据,这些患者在手术前1周完成了灌注闪烁扫描,并在术前、术后1个月、6个月和12个月进行了第一秒用力呼气量(FEV1)和肺一氧化碳弥散量(DLCO)评估。
术后1个月时,实际FEV1占预测值的百分比为术前值的77.9%,几乎与术后预测值相等,到6个月时显著增至84.3%,12个月时为84.2%。术后1个月时,实际DLCO占预测值的百分比为术前值的81.8%,与术后预测值相似,6个月时也显著增至91.3%,12个月时为96.5%。然而,慢性阻塞性肺疾病(COPD)患者或接受开胸手术或辅助化疗患者术后1年的实际肺功能测试结果与术后预测值并无差异。
与术后预测值相比,肺叶切除术后1年内实际肺功能随时间推移有所改善。然而,COPD患者或接受开胸手术或术后辅助化疗的患者未观察到这种改善。