| 多层螺旋CT肺气肿指数与肺叶切除术后并发症相关性研究 |
| 投稿时间：2015-01-26 修订日期：2015-01-27 点此下载全文 |
| 引用本文：李先浪,王晓荣.多层螺旋CT肺气肿指数与肺叶切除术后并发症相关性研究[J].医学研究杂志,2016,45(1):159-162 |
| DOI：
10.11969/j.issn.1673-548X.2016.01.041 |
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| 中文摘要:目的 探讨胸部多层螺旋CT(multi-slice CT,MSCT)的肺气肿指数(emphysema index,EI)对肺叶切除术后并发症发生的影响和预测能力。方法 回顾性分析2011年1月~2013年12月间于笔者医院行肺叶切除术,并且于手术前1个月内在笔者医院完成胸部CT及临床肺功能检查的患者。采用单因素和多因素Logistic回归分析术前EI与术后并发症发生的关系,并绘制受试者工作特征曲线(ROC曲线)评价EI值对术后并发症的预测能力。结果 共计242例患者纳入研究,原发性肺癌207例(85.5%),良性疾病35例(14.5%)。术后7例(2.89%)患者死亡,34例(14.04%)患者出现术后并发症,其中肺部感染14例,肺不张12例,呼吸衰竭8例。单因素分析结果显示,EI、年龄、性别、吸烟史、FEV1/FVC和手术方法与肺叶切除术后并发症发生有关。多因素Logistic回归分析显示,性别、EI和FEV1/FVC是影响患者术后并发症发生的独立因素,OR及95%CI分别是2.97(1.38~5.36)、1.53(1.12~2.19)和1.20(1.06~1.45)。进一步研究依据患者是否患有COPD将其分为两组,COPD组和非COPD组的多因素Logistic回归分析也均表明EI是影响患者术后并发症发生的独立因素。EI预测肺叶切除术后并发症发生的ROC曲线下面积为0.758。结论 EI值可以较好地评估和预测肺叶切除术后并发症的发生,对临床治疗具有一定指导意义。 |
| 中文关键词:肺叶切除术 肺气肿指数 并发症 危险因素 ROC曲线 |
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| Correlation between Preoperative Multi-slice CT Emphysema Index and the Occurrence of Pulmonary Complications after Pulmonary Lobectomy |
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| Abstract:Objective To analyze the relationship between preoperative emphysema index (EI) of Multi-slice computed tomography and the occurrence of pulmonary complications after pulmonary lobectomy, to further assess the impact of EI on the prognosis of postoperative complications. Methods We retrospectively reviewed patients who underwent pulmonary lobectomy in Lin'an People's Hospital from Jan 2011 to Dec 2013.All patients had finished chest computed tomography scans. Logistic regression analysis was used to evaluate the association between preoperative EI and postoperative complications. The receiver operating characteristic curve (ROC) was created to evaluate predictability of EI for postoperative complications. Results A total of 242 patients were evaluated. Pulmonary complications occurred in 34 patients (14.04%). The median EI was 10.05. Logistic regression analysis indicated that gender, EI and FEV1/FVC were risk factors for pulmonary complications for all patients. ORs (95%CI) were 2.97(1.38-5.36), 1.53(1.12-2.19) and 1.20(1.06-1.45), respectively. EI and age were risk factors for patients without chronic obstructive pulmonary disease. and EI and FEV1/FVC were risk factors for patients with chronic obstructive pulmonary disease. The area under the ROC curve in predicting complications was 0.758 for EI value. Conclusion The preoperative EI value is a significant risk factor for pulmonary complications after pulmonary lobectomy and might serve as a useful tool for predicting of postoperative complications. |
| keywords:Lobectomy Emphysema index Complication Risk factor ROC curve |
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