肺通气功能测定与食管、贲门癌术后并发症的关系

目的探讨术前肺通气功能各个指标对食管、贲门癌切除手术患者手术耐受力及术后并发症的预测能力,综合分析预测指标与食管、贲门癌术后并发症的关系。方法对26例食管、贲门癌手术患者进行术前肺通气功能检测,追踪手术患者术后1月内心肺并发症(PPC)的发生情况,综合分析肺功能指标对手术耐受力与PPC的评估能力。结果26例手术患者有8例术后1月内出现PPC(29.2%);有、无PPC组间存在统计学意义的肺功能指标有:FVC、FVC%pred、FEV1及MVV;术前FVC<2.0 L,PPC发生率是100%;术前FVC<60%pred,PPC发生率是100%;术前FEV1<1.5 L,PPC发生率是75%;术前MVV<50 L,PPC发生率是50%;不同年龄与PPC的发生无相关性。结论术前肺通气功能能够评估食管、贲门癌切除术患者的手术耐受力及术后并发症的发生,常规肺功能极低者发生PPC的机率大。

Evaluation of pulmonary function in postoperative complications of esophagogastrostomy for esophagus-cardiac carcinoma

Objective To investigate the value of preoperative pulmonary function in predicting postoperative pulmonary complications and respiratory function following esophagectomy and intrathoracic esophagogastrostomy for carcinoma of the esophagus and cardia.Methods Routine respiratory ventilation function were performed in 26 patients with esophagus-cardiac carcinoma.Postoperative pulmonary complications(PPC)in 26 patients within 1 month of carcinoma resection was observed. Analyze the pulmonary function testing parameters synthetically,assessing the tolerance of lung resection and PPC.Results PPC developed in 8 patients(29.2%);There were significant differences in pulmonary function parameters,such as FVC、FVC%pred、FEV1 and MVV between those without complications and those who experienced complications;Patients with preoperative FVC<2.0 L or Patients with preoperative FVC<60%pred had 100% morbidity of PPC;patients with preoperative FEV1< 1.5 L had 75% morbidity of PPC;or MVV%<50 L had 100% morbidity of PPC.There were no significant differences in age between those who did and those who did not experience complications.Conclusion Preoperative pulmonary function could assess tolerance and complication happening of esophagectomy and esophagogastrostomy for esophagus-cardiac carcinoma.Severe impairment in respiratory ventilation function was correlated with a high risk of postoperative pulmonary complications.