Evaluation of expiratory volume, diffusion capacity, and exercise tolerance following major lung resection - A prospective follow-up analysis
Evaluation of expiratory volume, diffusion capacity, and exercise tolerance following major lung resection - A prospective follow-up analysis
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DOI：
10.1378/chest.06-1345
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发表时间：
2007-01-01
期刊：
影响因子：
9.6
通讯作者：
Sabbatini, Armando
中科院分区：
文献类型：
--
作者：
Brunelli, Alessandro;Xiume, Francesci;Sabbatini, Armando
背景：肺切除决定一个可变的功能减少取决于切除的程度和手术的时间。本研究的目的是在重复评估次数下，前瞻性地研究大肺切除术后FEN'，、一氧化碳肺弥散能力（D-LCO）和运动耐量的变化。方法：采用爬楼梯试验计算200例患者术前、出院时、肺叶或全肺切除术后1个月和3个月的FEV1、DLCO和峰值耗氧量（Vo(2)峰）。比较术前和术后重复测量值，并进行时间序列、横断面回归分析，以确定与术后Vo(2)峰相关的因素。结果：肺叶切除术后1个月，FEV1、DLCO和Vo(2)Peak分别为术前的79.5%、81.5%和96%，3个月后恢复率分别为84%、88.5%和97%。肺切除术后1个月，预测FEV1百分比、预测DLCO百分比和Vo(2)峰值分别为术前的65%、75%和87%，3个月后分别为66%、80%和89%。肺叶切除术后3个月，27%的COPD患者FEV1改善，34%的DLCO改善，43%的Vo(2)峰值与术前相比有所改善。时间序列、横断面回归分析显示，术后Vo(2)峰值与术前Vo(2)峰值、术后FEV1、DLCO值直接相关，与年龄、体重指数呈负相关。结论：我们的研究结果可用于术前咨询和决定手术资格以及其他更传统的结果测量。
Background: Lung resections determine a variable functional reduction depending on the extent of the resection and the time elapsed from the operation. The objectives of this study were to prospectively investigate the postoperative changes in FEN',, carbon monoxide lung diffusion capacity (D-LCO), and exercise tolerance after major lung resection at repeated evaluation times.Methods: FEV1, DLCO, and peak oxygen consumption (Vo(2)peak) calculated using the stair climbing test were measured in 200 patients preoperatively, at discharge, and 1 month and 3 months after lobectomy or pneumonectomy. Preoperative and repeated postoperative measures were compared, and a time-series, cross-sectional regression analysis was performed to identify factors associated with postoperative Vo(2)peak.Results: One month after lobectomy, FEV1, DLCO, and Vo(2)Peak values were 79.5%, 81.5%, and 96% of preoperative values and recovered up to 84%, 88.5%, and 97% after 3 months, respectively. One month after pnemuonectomy, FEV1 percentage of predicted, DLCO percentage of predieted, and Vo(2)peak values were 65%, 75%, and 87% of preoperative values, and were 66%, 80%, and 89% after 3 months, respectively. Three months after lobectomy, 27% of patients with COPD had improved FEV1, 34% had improved DLCO, and 43% had improved Vo(2)peak compared to preoperative values. The time-series, cross-sectional regression analysis showed that postoperative Vo(2)peak values were directly associated with preoperative values of Vo(2)Peak, and postoperative values of FEV1 and DLCO, and were inversely associated with age and body mass index.Conclusions: Our findings may be used during preoperative counseling and for deciding eligibility for operation along with other more traditional measures of outcome.