弥散功能测定在预计肺癌肺切除手术后近期预后中的价值

目的　探讨肺癌肺切除手术前肺一氧化碳弥散功能 (DLCO)测定与手术后近期预后的关系。方法　对 413例肺切除手术前作过肺功能和DLCO测定的肺癌患者术后近期预后进行分析。其中2 7例术前DLCO降低 (全肺或二叶切除者 <6 0 %预计值、肺叶切除者 <5 0 %预计值 )者为DLCO降低(LDLCO)组 ,其余 3 86例为对照组。结果　LDLCO组与对照组相比 ,患者年龄偏大、伴有慢性支气管炎史、长期吸烟史以及术前化疗或放疗者明显增多 (P <0 .0 5 )。两组手术死亡率无显著差异 ,但LDLCO者术后易发生呼吸系统并发症。结论　术前DLCO降低可增加肺切除术后呼吸系统的并发症 ,术前DLCO测定对预计肺切除术后风险具有一定临床意义。

Value of pulmonary diffusion capacity in predicting the short term prognosis after lung resection in lung cancer patients

Objective To determine the relationship between pulmonary diffusion capacity (D LCO) and the short term prognosis after lung resection in patients with lung cancer. Methods A retrospective analysis of 413 consecutive patients with lung cancer who underwent lung resection was performed. Among them, 27 had low D LCO before operation (D LCO<60% predicted for total pneumonectomy or bilobectomy, <50% predicted for lobectomy), as a low D LCO (LD LCO) group,and other 386 patients as a control group.Results There were more patients with chronic bronchitis, history of heavy smoking and underwent chemotherapy or radiotherapy preoperatively in LD LCO group than those in control group. The hospital mortality rates within 30 days after lung resection were no significant difference between the two groups (P>0.05),whereas incidence of respiratory complications in LD LCO group was higher than that in control group (P<0.05). Conclusion A reduction in D LCO before operation can remarkably increase respiratory complications after pulmonary resection. D LCO is one of important predictors of risk for lung resection.