解剖肺切除风险分层中的非传统肺功能测试:一个回顾性审查
Christopher W Towe1, Avanti Badrinathan2, Alina Khil3
1Division of Thoracic and Esophageal Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106-5011, USA.
Therapeutic advances in respiratory disease
|December 16, 2024
概括
肺功能测试 (PFTs) 超出FEV1和DLCO,像FVC一样,可以改善预测肺切除后的术后并发症. 传统的PFT单独不足以准确地分层手术风险.
科学领域:
- 肺部医学 肺部医学
- 胸部外科手术 胸部外科手术
- 医学诊断 医学诊断 医学诊断
背景情况:
- 肺功能测试 (PFT) 建议在肺切除之前进行术前评估.
- 标准的PFT参数,如1秒内强制呼吸量 (FEV1) 和肺部对一氧化碳的扩散能力 (DLCO),往往对术后并发症具有有限的预测价值.
研究的目的:
- 调查PFT结果超出FEV1和DLCO是否与术后并发症有关.
- 确定替代PFT参数是否可以提高肺切除后并发症的预测.
主要方法:
- 一项回顾性队列研究分析了在2007年至2017年期间接受解剖肺切除的922名患者.
- 计算了百分比预测的术后 (ppo) PFT值,并使用单变量和多变量回归分析评估了它们与并发症的关联.
主要成果:
- 术后并发症发生在26.0%的患者中,死亡率为1.3%.
- 单变量分析表明,ppo强迫生命能力 (FVC),FEV1,FEF2575,DLCO,DLCO/VA和VC值预测了并发症.
- 多变量回归显示没有独立的预测关系,可能是由于PFT结果之间的对线性.
结论:
- 非传统的PFT,如FVC,可以改善肺切除后术后并发症的风险分层.
- 传统的参数 (FEV1,DLCO) 不能独立预测,这表明需要重新评估它们在手术风险评估中的孤立使用.
- 由于PFT结果之间的高度对齐性,因此需要重新考虑它们在手术风险分层中的应用.
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