Wahi R, McMurtrey M J, DeCaro L F, Mountain C F, Ali M K, Smith T L, Roth J A
Department of Thoracic Surgery, University of Texas, M.D. Anderson Cancer Center, Houston 77030.
Ann Thorac Surg. 1989 Jul;48(1):33-7. doi: 10.1016/0003-4975(89)90172-0.
A total of 197 consecutive patients undergoing pneumonectomy at the M.D. Anderson Cancer Center from 1982 to 1987 were reviewed. Sixty-five variables were analyzed for the predictive value for perioperative risk. The operative mortality rate was 7% (14/197). Patients having a right pneumonectomy (n = 95) had a higher operative mortality rate (12%) than patients having a left pneumonectomy (1%, p less than 0.05). The extent of resection correlated with the operative mortality rate (chest wall resection or extrapleural pneumonectomy, n = 39, 15%; versus simple or intrapericardial pneumonectomy, n = 158, 5%; p less than 0.05). Patients whose predicted postoperative pulmonary function, by spirometry and xenon 133 regional pulmonary function studies, was a forced expiratory volume in 1 second greater than 1.65 L, forced expiratory volume in 1 second greater than 58% of the preoperative value, forced vital capacity greater than 2.5 L, or forced vital capacity greater than 60% of the preoperative value had a lower operative mortality rate (p less than 0.05). Atrial arrhythmia was the most common postoperative complication (23%). Xenon 133 regional pulmonary function studies are useful in predicting the risks of pneumonectomy.
对1982年至1987年在MD安德森癌症中心接受肺切除术的197例连续患者进行了回顾性研究。分析了65个变量对围手术期风险的预测价值。手术死亡率为7%（14/197）。接受右肺切除术的患者（n = 95）手术死亡率（12%）高于接受左肺切除术的患者（1%，p < 0.05）。切除范围与手术死亡率相关（胸壁切除或胸膜外肺切除术，n = 39，15%；与单纯或心包内肺切除术，n = 158，5%；p < 0.05）。通过肺活量测定和氙133区域肺功能研究预测术后肺功能的患者，其一秒用力呼气量大于1.65 L、一秒用力呼气量大于术前值的58%、用力肺活量大于2.5 L或用力肺活量大于术前值的60%，手术死亡率较低（p < 0.05）。房性心律失常是最常见的术后并发症（23%）。氙133区域肺功能研究有助于预测肺切除术的风险。
