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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。
Objective To investigate the relationship between lung carbon monoxide diffusion (DLCO) measurement and short-term prognosis after lung resection. Methods The short-term prognosis of lung cancer patients undergoing lung function and DLCO determination before lung resection was analyzed. Of these, 27 patients with preoperative DLCO reduction (<60 % predicted for whole lung or bilobectomy and <5% predicted for lobectomy) were in the DLCO reduction (LDLCO) group and the remaining 3 86 were in the control group. Results Compared with the control group, patients in the LDLCO group had older age, history of chronic bronchitis, long-term smoking history, and significantly increased preoperative chemotherapy or radiotherapy (P < 0.05). There was no significant difference in operative mortality between the two groups, but LDLCO patients were prone to respiratory complications after surgery. Conclusion Preoperative DLCO reduction can increase the respiratory complications after lung resection. The preoperative DLCO test has certain clinical significance for the postoperative risk of lung resection.