Nagamatsu Y, Yamana H, Fujita H, Hiraki H, Matsuo T, Mitsuoka M, Hayashi A, Kakegawa T
First Department of Surgery, Kurume University School of Medicine, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1994 Nov;42(11):2037-40.
By analyzing expired gas with exercise testing, we examined the relationship between test results and postoperative cardiopulmonary complications. The analysis was evaluated for its accuracy and reliability in comparison with general pulmonary function tests including spirometry, flow volume curves, diffusing capacity and arterial blood gas analysis. Enrolled were 52 of patients admitted between a period from 1991 to 1993 for thoracic esophageal cancer, who underwent a radical operation of right thoracolaparotomy. Patients were divided into two groups according to postoperative cardiopulmonary complications; one with complications (group C, n = 11) and the other without complication (group NC = 41). The two groups were compared in maximum oxygen consumption (VO2 max)/m2, anaerobic threshold (AT)/m2, VC/m2, %VC, FEV1.0/m2, V25/m, V50/V25, %DLCO and PaO2. In the results, there were significant differences between the two groups only in VO2 max/m2 (p < 0.001), AT/m2 (p < 0.001), and V50/V25 (p < 0.05), while there were no significant differences between the two groups in VC/m2, %VC, FEV1.0/m2, FEV1.0%, V25/m, %DLCO or PaO2. The above results suggest that analysis of expired gas with exercise testing is able to measure easily both cardiac and pulmonary reserve forces, which conventional pulmonary function tests are unable to do, and is evaluating surgical indications for esophageal cancer patients and predicting postoperative cardiopulmonary complications.
通过运动试验分析呼出气体,我们研究了试验结果与术后心肺并发症之间的关系。与包括肺活量测定、流量容积曲线、弥散功能和动脉血气分析在内的常规肺功能测试相比,对该分析的准确性和可靠性进行了评估。纳入了1991年至1993年间因胸段食管癌入院并接受右胸腹腔镜根治性手术的52例患者。根据术后心肺并发症将患者分为两组;一组有并发症(C组,n = 11),另一组无并发症(NC组 = 41)。比较了两组的最大耗氧量(VO2 max)/m2、无氧阈值(AT)/m2、肺活量(VC)/m2、VC百分比、第一秒用力呼气容积(FEV1.0)/m2、V25/m、V50/V25、一氧化碳弥散量百分比(%DLCO)和动脉血氧分压(PaO2)。结果显示,两组之间仅在VO2 max/m2(p < 0.001)、AT/m2(p < 0.001)和V50/V25(p < 0.05)方面存在显著差异,而在VC/m2、VC百分比、FEV1.0/m2、FEV1.0%、V25/m、%DLCO或PaO2方面两组之间无显著差异。上述结果表明,运动试验分析呼出气体能够轻松测量心脏和肺储备功能,而这是传统肺功能测试无法做到的,并且有助于评估食管癌患者的手术指征并预测术后心肺并发症。