定量肺CT指标在肺癌激光切除过程中,在单肺通风过程中对低氧症有很好的预测能力
Jing Peng1, Liang Ma1, Fei Liao2
1Department of Anesthesiology, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Peking University Cancer Hospital Yunnan, No. 519 Kunzhou Road, Kunming, 650118, Yunnan, China.
在肺癌手术中,对依赖性肺部的手术前CT扫描测量可以预测在单肺通风 (OLV) 期间的低氧症. 这有助于麻醉师积极主动地管理患者.
科学领域:
- 麻醉学 麻醉学
- 胸部外科手术 胸部外科手术
- 肺部医学 肺部医学
背景情况:
- 单肺通风 (OLV) 对于肺癌患者的胸腔镜激素切除至关重要.
- 低氧症是OLV期间的重大并发症,需要确定风险.
- 术前评估对于在OLV期间管理潜在的低氧症至关重要.
研究的目的:
- 在接受胸腔镜手术的肺癌患者中,确定OLV期间低氧症的术前危险因素.
- 开发和验证OLV诱导的低血的预测模型.
主要方法:
- 对268名肺癌视频辅助胸腔镜手术 (VATS) 患者的回顾性研究.
- 后勤回归分析以确定缺氧血的独立手术前风险因素.
- 使用C指数和AUC的预测模型的开发和验证.
主要成果:
- 确定了关键的手术前风险因素:依赖性肺FLV与肺FLV总量的比率,依赖性肺HU值,依赖性肺LAV%,以及DLCO%前.
- 开发的预测模型显示了高预测效率.
- 内部验证得出C指数为0.963和AUC为0.96 (训练组) 和0.92 (测试组).
结论:
- 依赖性肺部的CT基定量指标是肺癌患者在OLV期间低氧化症的强有力的预测指标.
- 该预测模型使麻醉科医生能够预测和主动管理与OLV相关的低氧症.
- 基于这种预测模型,可以制定个性化麻醉管理策略.
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