Pulmonary arterial enlargement predicts cardiopulmonary complications after pulmonary resection for lung cancer: a retrospective cohort study.
Pulmonary arterial enlargement predicts cardiopulmonary complications after pulmonary resection for lung cancer: a retrospective cohort study.
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肺动脉肿大预测肺癌肺切除后心肺并发症：一项回顾性队列研究。
DOI：
10.1186/s13019-015-0315-9
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发表时间：
2015-09-09
影响因子：
1.6
通讯作者：
Watanabe K
中科院分区：
文献类型：
--
作者：
Asakura K;Mitsuboshi S;Tsuji M;Sakamaki H;Otake S;Matsuda S;Kaseda K;Watanabe K
据报道，在计算机断层扫描上发现的肺动脉增大与肺动脉高压有关。另一方面，肺动脉高压是胸外科手术的已知危险因素。我们调查了肺动脉增大是否预示肺癌肺切除术后的心肺并发症。我们回顾了237例因肺癌而接受肺切除术的患者。分析患者的术前特征(性别、年龄、Brinkman指数、心肺合并症、心胸比率、肺功能、肺动脉增大)和手术资料(手术方式、病理分期、术后并发症、死亡率、术后住院时间)。用胸部CT测量主肺动脉分叉处的直径和升主动脉最宽处的直径，并计算前者和后者的比值，以评价术前肺动脉的扩张情况。总共有16名患者发生了术后心肺并发症，221名患者没有发生。1例患者死于术后肺炎。术后发生心肺并发症患者的平均年龄显著高于无并发症患者(78 ± 5岁vs69 ± 9岁，P = 0.0001)。术后并发症组的肺动脉/升主动脉比值显著高于无并发症组(0.94 ± 0.15vs.0.81 ± 0.11，P = 0.03)。术前患者的其他特征和手术数据在两组之间没有显著差异。多因素分析发现，肺动脉/升主动脉比值(增加0.1点；优势比2.3%，95%可信区间1.5~3.5；P = 0.0002)和年龄(1年增加；优势比1.2，95%可信区间1.1~1.3；P = 0.03)是术后心肺并发症的独立预测因素。在计算机断层扫描上发现的肺动脉增大是肺癌术后心肺并发症的潜在预测指标。
The finding of pulmonary arterial enlargement on computed tomography has been reported to be associated with pulmonary hypertension. On the other hand, pulmonary hypertension is a known risk factor for thoracic surgery. We investigated whether pulmonary arterial enlargement predicts cardiopulmonary complications following pulmonary resection for lung cancer. We reviewed 237 consecutive patients who underwent pulmonary resection for lung cancer. Preoperative patient characteristics (sex, age, Brinkman index, cardiopulmonary comorbidities, cardiothoracic ratio, pulmonary function, and pulmonary arterial enlargement) and surgical data (surgical procedure, pathological stage, postoperative complications, mortality, and length of postoperative hospital stay) were analyzed. In order to evaluate preoperative pulmonary arterial enlargement, we measured the diameter of the main pulmonary artery at its bifurcation and that of the ascending aorta at its widest point using chest computed tomography and calculated the ratio of the former diameter to the latter. In all, 16 patients developed postoperative cardiopulmonary complications and 221 did not. One patient died from postoperative pneumonia. The mean age of patients who developed postoperative cardiopulmonary complications was significantly higher than that of those who did not (78 ± 5 years vs 69 ± 9 years, P = 0.0001). The pulmonary artery-to-ascending-aorta ratio was significantly higher in patients who developed postoperative complications than in those who did not (0.94 ± 0.15 vs. 0.81 ± 0.11, P = 0.03). Other preoperative patient characteristics and surgical data did not differ significantly between the groups. On multivariate analysis, pulmonary artery-to-ascending-aorta ratio (0.1-point increase; odds ratio 2.3, 95 % confidence interval 1.5–3.5; P = 0.0002) and age (1-year increase; odds ratio 1.2, 95 % confidence interval 1.1–1.3; P = 0.03) were found to be independent predictors of postoperative cardiopulmonary complications. A finding of pulmonary arterial enlargement on computed tomography is a potential predictor of postoperative cardiopulmonary complications after lung cancer surgery.