Zhou Kun, Wu Yanming, Su Jianhua, Lai Yutian, Shen Cheng, Li Pengfei, Che Guowei
Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Department of Rehabilitation, West China Hospital, Sichuan University, Chengdu 610041, China.
Zhongguo Fei Ai Za Zhi. 2017 Sep 20;20(9):603-609. doi: 10.3779/j.issn.1009-3419.2017.09.03.
Postoperative pulmonary complications (PPCs), especially postoperative pneumonia (POP), directly affect the rapid recovery of lung cancer patients after surgery. Peak expiratory flow (PEF) can reflect airway patency and cough efficiency. Moreover, cough impairment may lead to accumulation of pulmonary secretions which can increase the risk of PPCs. The aim of this study is to investigate the effect of preoperative PEF on PPCs in patients with lung cancer.
Retrospective research was conducted on 433 lung cancer patients who underwent lobectomy at the West China Hospital of Sichuan University from January 2014 to December 2015. The associations between preoperative PEF and PPCs were analyzed based on patients' basic characteristics and clinical data in hospital.
Preoperative PEF value in PPCs group (280.93±88.99) L/min was significantly lower than that in non-PPCs group (358.38±93.69) L/min (P<0.001). According to the binary logistics regression analysis, PEF and operative time were independent risk factors for PPCs. Further, ROC curve showed that PEF=320 L/min was the cut-off value for predicting the occurrence of PPCs (AUC=0.706, 95%CI: 0.661-0.749). The incidence of PPCs in PEF≤320 L/min group (26.6%) was significantly higher than that in PEF>320 L/min group (9.4%)(P<0.001).
Preoperative PEF and PPCs are correlated, and PEF may be used as a predictor of PPCs.
术后肺部并发症(PPCs),尤其是术后肺炎(POP),直接影响肺癌患者术后的快速康复。呼气峰值流速(PEF)可反映气道通畅情况及咳嗽效率。此外,咳嗽功能受损可能导致肺分泌物积聚,从而增加发生PPCs的风险。本研究旨在探讨术前PEF对肺癌患者PPCs的影响。
对2014年1月至2015年12月在四川大学华西医院接受肺叶切除术的433例肺癌患者进行回顾性研究。根据患者的基本特征和住院临床资料,分析术前PEF与PPCs之间的关联。
PPCs组术前PEF值为(280.93±88.99)L/分钟,显著低于非PPCs组的(358.38±93.69)L/分钟(P<0.001)。根据二元逻辑回归分析,PEF和手术时间是PPCs的独立危险因素。此外,ROC曲线显示,PEF=320 L/分钟是预测PPCs发生的临界值(AUC=0.706,95%CI:0.661-0.749)。PEF≤320 L/分钟组的PPCs发生率(26.6%)显著高于PEF>320 L/分钟组(9.4%)(P<0.001)。
术前PEF与PPCs相关,PEF可作为PPCs的预测指标。