肺切除术后肺功能评估中，肺量测定法是否足够？

Is Spirometry a Sufficient Test for Assessing Respiratory Function after Lung Resection?

机构信息

Division of Physical Therapy, Faculty of Health Sciences with the Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland.

Department of Thoracic Surgery, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland.

出版信息

Curr Oncol. 2024 Jul 11;31(7):3985-3993. doi: 10.3390/curroncol31070295.

DOI:10.3390/curroncol31070295

PMID:39057167

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11275653/

Abstract

BACKGROUND

The prediction of postoperative functional status in non-small cell lung cancer patients based on preoperative assessment of physical and respiratory capacity is inadequate based on recent RCTs.

MATERIAL AND METHODS

Prospectively collected spirometry data and the six-minute walk test results of 57 patients treated with lobectomy for non-small cell lung cancer were analyzed. The tests were performed before surgery, and 30 and 90 days after lobectomy. All patients underwent a respiratory functional and physical capacity assessment.

RESULTS

All 57 patients underwent lobectomy. Before surgery, mean FEV1 was 2.4 ± 0.7 L, corresponding to %FEV1 of 88.3 ± 17.3%. The mean absolute and expected 6MWT distance was 548 ± 74.6 m and 108.9 ± 14.5%, respectively. At the first postoperative evaluation 30 days after surgery, FEV1 and %FEV1 decreased significantly by an average of 0.5 ± 0.3 L and 15.1 ± 10.7%, while 6MWT and expected 6MWT decreased minimally by an average of 1.0 m and 0.8%, respectively. Three months after lobectomy, FEV1 and %FEV1, compared with the initial assessment, decreased by an average of 0.3 ± 0.3 l and 7.8 ± 10.0%, while 6MWT and its expected score increased to 564.6 ± 84.6 m and 112.8 ± 15.8%, respectively.

CONCLUSIONS

After lobectomy, FEV1 decreased slightly and less than expected, while 6MWT increased proportionally compared to the preoperative evaluation.

摘要

背景

基于最近的 RCT 结果，基于术前对身体和呼吸能力的评估，对非小细胞肺癌患者术后功能状态的预测并不充分。

材料和方法

分析了 57 例接受肺叶切除术治疗非小细胞肺癌患者的前瞻性收集的肺活量测定数据和 6 分钟步行测试结果。这些测试在手术前、手术后 30 天和 90 天进行。所有患者均进行了呼吸功能和身体能力评估。

结果

所有 57 例患者均接受了肺叶切除术。手术前，平均 FEV1 为 2.4 ± 0.7 L，对应于 %FEV1 为 88.3 ± 17.3%。平均绝对和预期 6MWT 距离分别为 548 ± 74.6 m 和 108.9 ± 14.5%。术后首次评估在手术后 30 天，FEV1 和 %FEV1 分别平均下降 0.5 ± 0.3 L 和 15.1 ± 10.7%，而 6MWT 和预期 6MWT 仅分别平均下降 1.0 m 和 0.8%。肺叶切除术后 3 个月，与初始评估相比，FEV1 和 %FEV1 平均下降 0.3 ± 0.3 L 和 7.8 ± 10.0%，而 6MWT 及其预期评分增加至 564.6 ± 84.6 m 和 112.8 ± 15.8%。