通气效率和静息潮气末二氧化碳分压对肺癌切除术后心肺并发症的预测价值
Predictive value of ventilation efficiency and partial pressure of carbon dioxide at the end of resting moisture in cardiopulmonary complications after lung cancer resection
魏丽丽 1孙嗣善 1韩锦胜2
作者信息
- 1. 061001 河北沧州 河北省沧州中西医结合医院ICU
- 2. 061001 河北省沧州中西医结合医院胸外科
- 折叠
摘要
目的 分析每分钟通气量与二氧化碳输出量(VE/VCO2)斜率和静息潮气末二氧化碳分压(PetCO2)对肺癌切除术后心肺并发症的预测价值.方法 收集 2020 年 3 月至 2023 年 11 月期间 201 例接受肺切除手术的早期非小细胞肺癌患者.所有患者术前均进行肺功能检查、心肺运动试验.随访记录患者术后 30d内的术后心肺并发症、重症监护病房(ICU)住院时间(LOS)、医院LOS、ICU再次入住率和死亡率.结果 共有 32 例患者发生术后心肺并发症,纳入并发症组,其余患者纳入无并发症组(n=169).并发症组患者的医院LOS、ICU LOS、ICU再次入住率均高于无并发症组(P＜0.05).与无并发症组相比,并发症组静息PetCO2、VE/VCO2斜率显著升高(P＜0.05).经单因素及多因素Logistics分析,静息PetCO2、VE/VCO2斜率为肺癌切除术后发生心肺并发症的独立影响因素(P＜0.05).静息PetCO2 预测肺癌切除术后发生心肺并发症的受试者工作特征曲线下面积为 0.810(95%CI:0.741～0.880),与VE/VCO2斜率[0.795(95%CI:0.720～0.871)]无显著差异.经Spearman秩相关分析及多元线性回归校正,静息PetCO2 与ICU LOS(r=-0.295,P＜0.001)、医院LOS((V-0.271,P＜0.001)呈负相关;VE/VCO2斜率与ICU LOS(r=0.314,P＜0.001)、医院LOS(r=0.301,P＜0.001)呈正相关.结论 静息PetCO2 和VE/VCO2斜率预测肺癌切除术后心肺并发症效能相似,这表明静息PetCO2 可以作为不能或不愿意接受CPET的患者的VE/VCO2斜率替代品.
Abstract
Objective To analyze the value of the slope of VE/VCO2 per minute and the partial pressure of end-tidal carbon dioxide(PetCO2)in predicting cardiopulmonary complications after lung cancer resection.Methods 201 patients with early-stage non-small cell lung cancer who underwent lung resection between March 2020 and November 2023 were collected.All patients underwent pulmonary function examination and cardiopulmonary exercise test before operation.Postoperative cardiopulmonary complications,length of stay(LOS)in the intensive care unit(ICU),hospital LOS,ICU re-admission rate,and mortality were recorded within 30 days after surgery.Results A total of 32 patients with postoperative cardiopulmonary complications were included in the complication group,and the other patients were included in the non-complication group(n=169).The hospital LOS,ICU LOS and ICU re-occupancy rates in the complication group were higher than those in the non-complication group(P＜0.05).Compared with the non-complication group,the resting PetCO2 and VE/VCO2 slopes of the complication group were significantly increased(P＜0.05).Through univariate and multifactorial Logistics analysis,resting PetCO2 and VE/VCO2 slope were independent influencing factors for the occurrence of cardiopulmonary complications after lung cancer resection(P＜0.05).The area under the working characteristic curve of resting PetCO2 for predicting cardiopulmonary complications after lung cancer resection was 0.810(95%CI:0.741-0.880),which was not significantly different from the VE/VCO2 slope[0.795(95%CI:0.720-0.871)].After Spearman rank correlation analysis and multiple linear regression correction,resting PetCO2 was negatively correlated with ICU LOS(P＜0.001)and hospital LOS(P＜0.001).VE/VCO2 slope was positively correlated with ICU LOS(P＜0.001)and hospital LOS(P＜0.001).Conclusion The efficacy of resting PetCO2 and VE/VCO2 slope in predicting cardiopulmonary complications after lung cancer resection is similar,suggesting that resting PetCO2 can be used as a substitute for VE/VCO2 slope in patients who are unable or unwilling to receive CPET.
关键词
每分钟通气量与二氧化碳输出量/静息潮气末二氧化碳分压/肺癌/肺切除术/心肺并发症Key words
Slope of ratio of minute ventilation to carbon dioxide production/Partial pressure of end-tidal carbon dioxide at rest/Lung cancer/Pneumonectomy/Cardiopulmonary complications引用本文复制引用
出版年
2024
NETL
NSTL
万方数据