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慢性阻塞性肺疾病全球倡议(GOLD)分组对手术并发症的影响

Impact of GOLD groups of chronic pulmonary obstructive disease on surgical complications.

作者信息

Kim Hyung-Jun, Lee Jinwoo, Park Young Sik, Lee Chang-Hoon, Lee Sang-Min, Yim Jae-Joon, Yoo Chul-Gyu, Kim Young Whan, Han Sung Koo, Choi Sun Mi

机构信息

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.

出版信息

Int J Chron Obstruct Pulmon Dis. 2016 Feb 10;11:281-7. doi: 10.2147/COPD.S95046. eCollection 2016.

Abstract

PURPOSE

Chronic obstructive pulmonary disease (COPD) is associated with increased postoperative complications. Recently, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classified COPD patients into four groups based on spirometry results and the severity of symptoms. The objective of this study was to evaluate the impact of GOLD groups on postoperative complications.

PATIENTS AND METHODS

We reviewed the medical records of COPD patients who underwent preoperative spirometry between April and August 2013 at a tertiary hospital in Korea. We divided the patients into GOLD groups according to the results of spirometry and self-administered questionnaires that assessed the symptom severity and exacerbation history. GOLD groups, demographic characteristics, and operative conditions were analyzed.

RESULTS

Among a total of 405 COPD patients, 70 (17.3%) patients experienced various postoperative complications, including infection, wound, or pulmonary complications. Thoracic surgery, upper abdominal surgery, general anesthesia, large estimated blood loss during surgery, and longer anesthesia time were significant risk factors for postoperative complications. Patients in high-risk group (GOLD groups C or D) had an increased risk of postoperative complications compared to those in low-risk group (GOLD groups A or B).

CONCLUSION

COPD patients in GOLD groups representing a high exacerbation risk have an increased risk of postoperative complications compared to those with low risk.

摘要

目的

慢性阻塞性肺疾病(COPD)与术后并发症增加相关。最近,慢性阻塞性肺疾病全球倡议组织(GOLD)根据肺功能测定结果和症状严重程度将COPD患者分为四组。本研究的目的是评估GOLD分组对术后并发症的影响。

患者与方法

我们回顾了2013年4月至8月在韩国一家三级医院接受术前肺功能测定的COPD患者的病历。我们根据肺功能测定结果以及评估症状严重程度和加重病史的自我管理问卷将患者分为GOLD组。对GOLD分组、人口统计学特征和手术情况进行了分析。

结果

在总共405例COPD患者中,70例(17.3%)患者出现了各种术后并发症,包括感染、伤口或肺部并发症。胸外科手术、上腹部手术、全身麻醉、手术期间预计失血量较大以及麻醉时间较长是术后并发症的重要危险因素。与低风险组(GOLD A组或B组)患者相比,高风险组(GOLD C组或D组)患者术后并发症风险增加。

结论

与低风险的COPD患者相比,GOLD分组中代表高加重风险的患者术后并发症风险增加。

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