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先天性肺畸形胸腔镜肺叶切除术和肺段切除术后的中期肺功能测试:与正常对照的比较研究

Medium-Term Pulmonary Function Test After Thoracoscopic Lobectomy and Segmentectomy for Congenital Lung Malformation: A Comparative Study With Normal Control.

作者信息

Huang Jin-Xi, Hong Song-Ming, Hong Jun-Jie, Chen Qiang, Cao Hua

机构信息

Department of Cardiothoracic Surgery, Fujian Branch of Shanghai Children's Medical Center, Fuzhou, China.

Fujian Children's Hospital, Fuzhou, China.

出版信息

Front Pediatr. 2021 Oct 27;9:755328. doi: 10.3389/fped.2021.755328. eCollection 2021.

Abstract

This study aimed to compare the outcomes and pulmonary function test (PFT) of thoracoscopic segmentectomy and lobectomy in infants with congenital lung malformation and study the result of PFT on a medium-term basis. The clinical data of 19 infants with congenital lung malformation who underwent thoracoscopic surgery in our hospital from January 2018 to March 2019 were retrospectively studied; these infants were paired with another 19 infants who underwent thoracoscopic lobectomy during the same period using propensity score matching. Age-matched healthy individuals with similar body sizes were recruited for PFT as the control group. Patient characteristics, postoperative PFT, and outcomes were extracted for statistical analysis. The average length of hospital stay did not significantly differ between segmentectomy and lobectomy groups. The segmentectomy group had more chest tube drainage than the lobectomy group. PFT 1 month after the operation showed that the tidal volume of the lobectomy group was lower than that of the segmentectomy group. Time to peak expiratory flow/time of expiration and peak flow/terminal airway velocity (V25%) indicated small airway dysfunction in the lobectomy group, and no obvious abnormalities were found in "time of inspiratory/time of expiration" in either group. Reexamination of pulmonary function 2 years after the operation showed that the small airway function of the segmentectomy group returned to normal, and no significant difference in pulmonary function was noted among the three groups. The short-term pulmonary function recovery was better after segmentectomy than after lobectomy. Patients who underwent thoracoscopic lobectomy and segmentectomy have normal lung function 2 years after the operation.

摘要

本研究旨在比较先天性肺发育不良婴儿行胸腔镜肺段切除术和肺叶切除术的疗效及肺功能测试(PFT),并对PFT进行中期研究。回顾性研究了2018年1月至2019年3月在我院接受胸腔镜手术的19例先天性肺发育不良婴儿的临床资料;采用倾向评分匹配法将这些婴儿与同期接受胸腔镜肺叶切除术的另外19例婴儿配对。招募年龄匹配、体型相似的健康个体进行PFT作为对照组。提取患者特征、术后PFT和疗效进行统计分析。肺段切除术组和肺叶切除术组的平均住院时间无显著差异。肺段切除术组的胸腔闭式引流量多于肺叶切除术组。术后1个月的PFT显示,肺叶切除术组的潮气量低于肺段切除术组。呼气峰流速时间/呼气时间和峰流速/终末气道流速(V25%)表明肺叶切除术组存在小气道功能障碍,两组的“吸气时间/呼气时间”均未发现明显异常。术后2年复查肺功能显示,肺段切除术组的小气道功能恢复正常,三组间肺功能无显著差异。肺段切除术后的短期肺功能恢复优于肺叶切除术后。接受胸腔镜肺叶切除术和肺段切除术的患者术后2年肺功能正常。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ea4/8578933/aa06f3dd6301/fped-09-755328-g0001.jpg

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