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爬楼梯试验可预测非小细胞肺癌患者术后心肺并发症及住院时间。

Stair-Climbing Test Predicts Postoperative Cardiopulmonary Complications and Hospital Stay in Patients with Non-Small Cell Lung Cancer.

作者信息

Dong Jingsi, Mao Yousheng, Li Jiagen, He Jie

机构信息

Department of Thoracic Surgery, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China (mainland).

出版信息

Med Sci Monit. 2017 Mar 24;23:1436-1441. doi: 10.12659/msm.900631.

Abstract

BACKGROUND There is currently no reliable method to predict major postoperative cardiopulmonary complications for patients with non-small cell lung cancer (NSCLC). In this study, we hypothesized that exercise oxygen desaturation (EOD) and heart rate change results in a stair-climbing test (SCT) would predict postoperative cardiopulmonary complications for patients with NSCLC. MATERIAL AND METHODS We examined 171 patients (41 females and 130 males) with NSCLC by preoperative SCT from January 2010 to July 2015. Among them, 27 underwent wedge resection, 122 underwent lobectomy, and 22 underwent pneumonectomy. The correlation between postoperative cardiopulmonary complications and parameters of SCT and pulmonary function test (PFT) parameters were analyzed retrospectively. RESULTS The overall 30-day postoperative morbidity of the patients was 46/171 (26.9%), with death occurring in 3/171(1.8%). The age, FEV1%, MVV, height of climbing, EOD, and heart rate change were found to be significantly different between the group with postoperative cardiopulmonary complications and those without. Binary logistic regression analysis showed that EOD and heart rate change were independently correlated with postoperative cardiopulmonary complications. In addition, a model predicting the probability of postoperative cardiopulmonary complication based on logistic regression for multivariable analysis was used to confirm our findings. CONCLUSIONS A symptom-limited SCT with oxygen saturation monitoring is a safe, simple, and low-cost method to evaluate cardiopulmonary function preoperatively.

摘要

背景

目前尚无可靠方法预测非小细胞肺癌(NSCLC)患者术后的主要心肺并发症。在本研究中,我们假设运动性氧饱和度下降(EOD)以及爬楼梯试验(SCT)中的心率变化可预测NSCLC患者术后的心肺并发症。材料与方法:我们对2010年1月至2015年7月期间171例NSCLC患者(41例女性和130例男性)进行了术前SCT检查。其中,27例行楔形切除术,122例行肺叶切除术,22例行全肺切除术。回顾性分析术后心肺并发症与SCT参数及肺功能测试(PFT)参数之间的相关性。结果:患者术后30天的总体发病率为46/171(26.9%),死亡3/171(1.8%)。发现术后出现心肺并发症的组与未出现并发症的组在年龄、第一秒用力呼气量百分比(FEV1%)、最大通气量(MVV)、爬楼梯高度、EOD及心率变化方面存在显著差异。二元逻辑回归分析表明,EOD和心率变化与术后心肺并发症独立相关。此外,使用基于多变量分析的逻辑回归预测术后心肺并发症概率的模型来证实我们的发现。结论:进行症状限制性SCT并监测氧饱和度是一种安全、简单且低成本的术前评估心肺功能的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/930b/5378276/3cb8f5bde1c0/medscimonit-23-1436-g001.jpg

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