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首页> 外文期刊>World Journal of Gastroenterology >Pulmonary complications in patients with chronic obstructive pulmonary disease following transthoracic esophagectomy.
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Pulmonary complications in patients with chronic obstructive pulmonary disease following transthoracic esophagectomy.

机译：经胸食管切除术后慢性阻塞性肺疾病患者的肺部并发症。

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AIM: To investigate the incidence of various types of postoperative pulmonary complications (POPCs) and to evaluate the significance of perioperative arterial blood gases in patients with esophageal cancer accompanied with chronic obstructive pulmonary disease (COPD) after esophagectomy. METHODS: Three hundred and fifty-eight patients were divided into POPC group and COPD group. We performed a retrospective review of the 358 consecutive patients after esophagectomy for esophageal cancer with or without COPD to assess the possible influence of COPD on postoperative pulmonary complications. We classified COPD into four grades according to percent-predicted forced expiratory volume in 1 s (FEV1) and analyzed the incidence rate of complications among the four grades. Perioperative arterial blood gases were tested in patients with or without pulmonary complications in COPD group and compared with POPC group. RESULTS: Patients with COPD (29/86, 33.7%) had more pulmonary complications than those without COPD (36/272, 13.2%) (P < 0.001). Pneumonia (15/29, 51.7%), atelectasis (13/29, 44.8%), prolonged O(2) supplement (10/29, 34.5%), and prolonged mechanical ventilation (8/29, 27.6%) were the major complications in COPD group. Moreover, patients with severe COPD (gradeIIB, FEV1<50% of predicted) had more POPCs than those with moderate(gradeIIA, 50%-80% of predicted) and mild (gradeI> or =80% of predicted) COPD (P < 0.05). PaO(2) was decreased and PaCO(2) was increased in patients with pulmonary complications in COPD group in the first postoperative week. CONCLUSION: The criteria of COPD are the critical predictor for pulmonary complications in esophageal cancer patients undergoing esophagectomy. Severity of COPD affects the incidence rate of the pulmonary complication, and percent-predicted FEV1 is a good predictive variable for pulmonary complication in patients with COPD. Arterial blood gases are helpful in directing perioperative management.
机译：目的：探讨食管癌合并慢性阻塞性肺疾病（COPD）的食管癌患者术后各种类型肺部并发症（POPCs）的发生率，并评估围手术期动脉血气的意义。方法：358例患者分为POPC组和COPD组。我们对358例食管癌术后伴或不伴COPD的连续患者进行了回顾性评估，以评估COPD对术后肺部并发症的可能影响。我们根据1 s内预测的强制呼气量（FEV1）将COPD分为四个等级，并分析了四个等级中并发症的发生率。对COPD组有或无肺部并发症的患者进行围手术期动脉血气测试，并与POPC组进行比较。结果：COPD患者（29 / 86，33.7％）比无COPD患者（36 / 272，13.2％）有更多的肺部并发症（P <0.001）。肺炎（15/29，51.7％），肺不张（13/29，44.8％），延长的O（2）补充（10/29，34.5％）和延长的机械通气（8/29，27.6％）是主要的COPD组并发症。此外，重度COPD（IIB级，FEV1 <预测值的50％）的患者的POPC比中度（IIA级，预测值的50％-80％）和轻度（I>级或= 80％的）COPD的患者多（P < 0.05）。术后第一周，COPD组肺部并发症患者的PaO（2）降低且PaCO（2）增加。结论：COPD的标准是食管癌食管癌患者肺部并发症的关键预测指标。 COPD的严重程度会影响肺部并发症的发生率，而百分比预测的FEV1是COPD患者肺部并发症的良好预测变量。动脉血气有助于指导围手术期管理。

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