Lin Chen, Wang Pei-Pei, Wang Zi-Yan, Lan Guo-Ru, Xu Kai-Wen, Yu Chun-Hua, Wu Bin
Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
School of Medicine, Tsinghua University, Beijing 100084, China.
World J Gastrointest Surg. 2024 Aug 27;16(8):2649-2661. doi: 10.4240/wjgs.v16.i8.2649.
Postoperative pulmonary complications (PPCs) are common in patients who undergo colorectal surgery. Studies have focused on how to accurately diagnose and reduce the incidence of PPCs. Lung ultrasound has been proven to be useful in preoperative monitoring and postoperative care after cardiopulmonary surgery. However, lung ultrasound has not been studied in abdominal surgeries and has not been used with wearable devices to evaluate the influence of postoperative ambulation on the incidence of PPCs.
To investigate the relationship between lung ultrasound scores, PPCs, and postoperative physical activity levels in patients who underwent colorectal surgery.
In this prospective observational study conducted from November 1, 2019 to August 1, 2020, patients who underwent colorectal surgery underwent daily bedside ultrasonography from the day before surgery to postoperative day (POD) 5. Lung ultrasound scores and PPCs were recorded and analyzed to investigate their relationship. Pedometer bracelets measured the daily movement distance for 5 days post-surgery, and the correlation between postoperative activity levels and lung ultrasound scores was examined.
Thirteen cases of PPCs was observed in the cohort of 101 patients. The mean (standard deviation) peak lung ultrasound score was 5.32 (2.52). Patients with a lung ultrasound score of ≥ 6 constituted the high-risk group. High-risk lung ultrasound scores were associated with an increased incidence of PPCs after colorectal surgery (logistic regression coefficient, 1.715; odds ratio, 5.556). Postoperative movement distance was negatively associated with the lung ultrasound scores [Spearman's rank correlation coefficient (), -0.356, < 0.05].
Lung ultrasound effectively evaluates pulmonary condition post-colorectal surgery. Early ambulation and respiratory exercises in the initial two PODs will reduce PPCs and optimize postoperative care in patients undergoing colorectal surgery.
术后肺部并发症（PPCs）在接受结直肠手术的患者中很常见。研究主要集中在如何准确诊断和降低PPCs的发生率。肺超声已被证明在心肺手术后的术前监测和术后护理中有用。然而，肺超声在腹部手术中尚未得到研究，也未与可穿戴设备一起用于评估术后活动对PPCs发生率的影响。
探讨接受结直肠手术患者的肺超声评分、PPCs与术后身体活动水平之间的关系。
在这项于2019年11月1日至2020年8月1日进行的前瞻性观察研究中，接受结直肠手术的患者从手术前一天至术后第5天每天进行床边超声检查。记录并分析肺超声评分和PPCs，以研究它们之间的关系。计步器手环测量术后5天的每日活动距离，并检查术后活动水平与肺超声评分之间的相关性。
在101例患者队列中观察到13例PPCs。肺超声评分峰值的平均值（标准差）为5.32（2.52）。肺超声评分≥6的患者构成高危组。高危肺超声评分与结直肠手术后PPCs发生率增加相关（逻辑回归系数，1.715；比值比，5.556）。术后活动距离与肺超声评分呈负相关[Spearman等级相关系数（），-0.356，<0.05]。
肺超声可有效评估结直肠手术后的肺部状况。术后前两天早期活动和呼吸锻炼将减少PPCs，并优化接受结直肠手术患者的术后护理。
