术前肺功能参数预测低肺功能患者肺癌根治术后并发呼吸衰竭的评价

目的对拟行肺癌根治术的低肺功能患者进行常规肺功能检测和脉冲强迫振荡技术（IOS）检测，评价术前肺功能参数预测低肺功能患者肺癌根治术后并发呼吸衰竭的价值。方法按照常规肺功能评价标准和术前肺功能测定结果，选择52例拟行肺癌根治术、低肺功能患者，根据术后是否发生呼吸衰竭分为呼衰组和非呼衰组。术前检测常规肺功能参数：第1秒用力呼气容积（FEV1．0）、肺活量（VC）及最大通气量（MVV）；IOS检测参数：周边气道阻力（R5-R20）、弹性阻力（X5）、共振频律（Fres）。结果两组FEV1．0、R5-R50、X5、Fres差异有统计学意义（P〈0．05）；Logisfic回归分析显示仅Fres为预测术后呼吸衰竭发生的独立因素（P〈0．01）。结论Fres有助于预测低肺功能肺癌患者全肺切除术后是否发生呼吸衰竭。

Preoperative lung function tests for prediction of postoperative respiratory failure after lung surgery in patients with compromised lung function

Objective To evaluate the possibility of using preoperative conventional lung function tests and impulse oscilloresistometry system (IOS) to predict the development of postoperative respiratory failure after radical lung cancer surgery in patients with poor pulmonary function. Methods Fifty-two male patients with lung cancer between 51-63 yrs undergoing radical lung cancer surgery were included in this study. Preoperative pulmonary function was assessed by conventional lung function tests ( FEV1.0 , VC, MVV) and impulse oscilloresistometry system (IOS) (peripheral airway resistance R5-R20; elastic resistance ( X5 ) and Fres. Postoperative respiratory failure was defined as short of breath (SOB) , cyanosis, SpO2 < 85% , PaO2 < 55 mm Hg and/or PaCO2 > 45 mm Hg.Results Nine patients developed postoperative respiratory failure (17.3%). There was significant difference in FEV1.0 , R5-R20, X5 and Fres between patients who developed postoperative respiratory failure and those who did not. Logistic regression analysis showed that Fres is an independent factor predicting respiratory failure. Conclusion Fres is an important parameter of impulse oscilloresistometry system (IOS) for prediction of postoperative respiratory failure after lung cancer surgery in patients with poor pulmonary function.