国际肿瘤学杂志

国际肿瘤学杂志 ›› 2019, Vol. 46 ›› Issue (8): 471-474.doi: 10.3760/cma.j.issn.1673-422X.2019.08.005

• 论著 • 上一篇    下一篇

食管癌开胸术患者术后肺部感染与术前肺功能指标的相关性

侯海生1    王秋艳 2   陈少川2   

  1. 1河北省秦皇岛军工医院急诊科    066000；2河北省秦皇岛军工医院重症医学科    066000
  • 收稿日期:2019-03-04 修回日期:2019-05-15 出版日期:2019-08-08 发布日期:2019-10-31
  • 通讯作者: 侯海生 E-mail:d6q6c0@163.com

Correlation between pulmonary infection and preoperative pulmonary function indexes in patients with esophageal cancer undergoing thoracotomy

Hou Haisheng1, Wang Qiuyan2, Chen Shaochuan2   

  1. 1Department of Emergency, Qinhuangdao Military Industrial Hospital of Hebei Province, Qinhuangdao 066000, China; 2Department of Critical Care Medicine, Qinhuangdao Military Industrial Hospital of Hebei Province, Qinhuangdao 066000, China
  • Received:2019-03-04 Revised:2019-05-15 Online:2019-08-08 Published:2019-10-31
  • Contact: Hou Haisheng E-mail:d6q6c0@163.com

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摘要： 目的    探讨食管癌患者采取开胸术后肺部感染的发生与术前肺功能指标的关系，为降低术后肺部感染发生率提供临床理论依据。方法    回顾性分析2017年5月至2018年5月于河北省秦皇岛军工医院就诊并行开胸手术的80例食管癌患者的临床资料，根据术后是否发生肺部感染分成感染组与未感染组；对比分析两组术前肺功能指标最大自主通气量（MVV）、最大自主通气量占预计值百分比（MVV%pred）、用力肺活量（FVC）、用力肺活量占预计值百分比（FVC%pred）、第1秒用力呼气容积（FEV1）、第1秒用力呼气容积占预计值百分比（FEV1%pred）、呼气流量峰值（PEF）、呼气流量峰值占预计值百分比（PEF%pred）；应用logistic回归分析肺功能指标与术后肺部感染的相关性。结果    80例食管癌开胸术患者有24例（30.00%）术后出现肺部感染。患者性别（t=1.755，P=0.086）、民族（t=2.125，P=0.073）与术后肺部感染严重程度无关。而年龄（t=4.084，P=0.024）、吸烟史（t=5.881，P=0.001）、手术时长（t=3.583，P=0.041）、术中出血量（t=5.115，P=0.003）及合并基础疾病（t=4.574，P=0.018）与术后肺部感染严重程度显著相关。肺功能指标中的MVV（χ2=4.242，P=0.039）、MVV%pred（χ2=4.405，P=0.036）、FVC（χ2=17.500，P＜0.001）、FVC%pred（χ2=12.382，P<0.001）、FEV1（χ2=12.070，P=0.001）与肺部感染发生相关。FVC（OR=9.102,95%CI为2.691~28.213，P=0.027）、FEV1（OR=21.621,95%CI为8.956~81.145，P=0.002）及MVV%pred（OR=5.648,95%CI为2.979~15.248，P=0.001）是肺部感染的高危因素。结论    术前部分肺功能指标与术后肺部感染显著相关，临床应加强对患者术前肺功能的检测和改善，降低肺部感染发生率。

关键词: 食管肿瘤, 呼吸功能试验, 肺炎

Abstract: Objective  To explore the correlation between the occurrence of pulmonary infection after thoracotomy and preoperative pulmonary function indexes in patients with esophageal cancer, and to provide clinical theoretical basis for reducing the incidence of pulmonary infection after thoracotomy. Methods  The clinical data of 80 patients with esophageal cancer who underwent thoracotomy from May 2017 to May 2018 in Qinhuangdao Military Industrial Hospital of Hebei Province were retrospectively analyzed. The patients were divided into infected group and uninfected group according to whether pulmonary infection occurred after operation. The preoperative maximal voluntary ventilation (MVV), MVV as a percentage of predicted value (MVV%pred), forced vital capacity (FVC), FVC as a percentage of predicted value (FVC%pred), forced expiratory volume in one second (FEV1), FEV1 as a percentage of predicted value (FEV1%pred), peak expiratory flow (PEF), PEF as a percentage of predicted value (PEF%pred) of the two groups were compared and analyzed. Logistic regression was used to analyze the correlation between pulmonary function indexes and postoperative pulmonary infection. Results  Postoperative pulmonary infection occurred in 24 out of 80 patients (30.00%). There was no correlation between gender (t=1.755, P=0.086), nationality (t=2.125, P=0.073) and the severity of pulmonary infection after operation. Age (t=4.084, P=0.024), smoking history (t=5.881, P=0.001), operation duration (t=3.583, P=0.041), intraoperative bleeding volume (t=5.115, P=0.003) and combined basic diseases (t=4.574, P=0.018) were significantly correlated with the severity of pulmonary infection after operation. MVV (χ2=4.242, P=0.039), MVV%pred (χ2=4.405, P=0.036), FVC (χ2=17.500, P<0.001), FVC%pred (χ2=12.382, P<0.001), FEV1 (χ2=12.070, P=0.001) were associated with pulmonary infection. FVC (OR=9.102, 95%CI: 2.691-28.213, P=0.027), FEV1 (OR=21.621, 95%CI: 8.956-81.145, P=0.002) and MVV%pred (OR=5.648, 95%CI: 2.979-15.248, P=0.001) were high risk factors for pulmonary infection. Conclusion  Partial pulmonary function indexes are significantly associated with postoperative pulmonary infection. It is necessary to strengthen the detection and improvement of preoperative pulmonary function in order to reduce the incidence of pulmonary infection.

Key words: Esophageal neoplasms, Respiratory function tests, Pneumonia