在接受心脏手术的左心室功能障碍和/或充血性心力衰竭患者中,是否应该进行常规的肺功能测试?
Turki B Albacker1, Abdulaziz M Alhothali2, Amr A Arafat3,4
1Cardiac Surgery Division, Cardiac Sciences Department, College of Medicine Consultant Cardiac & Aortic Surgeon, King Fahad Cardiac Center, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia. talbacker@ksu.edu.sa.
Journal of cardiothoracic surgery
|August 28, 2024
概括
手术前的肺功能测试对于心力衰竭的心脏手术患者来说是有价值的. 中度至严重的减少表明,呼吸持续时间和死亡率的风险更高.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 胸部外科手术 胸部外科手术
背景情况:
- 评估心脏手术患者常规使用肺功能测试 (PFTs) 仍然存在争议.
- 这项研究专门研究了由于左心室功能障碍或左心病导致的充血性心力衰竭 (CHF) 患者中PFT的预后价值.
研究的目的:
- 确定手术前肺功能测试在接受心脏手术的充血性心力衰竭患者的预后意义.
- 为了评估PFT结果和手术后结果之间的关联,在这个特定的患者队列.
主要方法:
- 一项回顾性研究涉及366名心脏衰竭患者,这些患者接受了心脏手术,并进行了手术前的PFT.
- 根据PFT结果,患者被分为两组:正常/轻度减少 (组1) 和中度/严重减少 (组2).
- 倾向性得分匹配用于平衡组之间的术前和术后特征.
主要成果:
- 在匹配后,分析了111对. 第二组 (中度/严重的PFT减轻) 显示机械通风持续时间显著更长 (12比9小时,p<0.001).
- 第二组也表现出更高的术后肌水平 (p=0.02) 和显著增加的医院死亡率 (6.31%对0%,p=0.02).
结论:
- 在接受心脏手术的左心室功能障碍和/或CHF患者中,应定期考虑进行手术前的肺功能测试.
- 中度至严重的PFT减少与不良的术后结果有关,包括长时间的通风和增加的医院死亡率.
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