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目的分析术前肺功能及强迫振荡肺功能(FOT)检查在预测术后呼衰中的临床价值。方法对473例肺切除患者术前除常规肺功能检查外均进行强迫振荡肺功能检测,以术后是否发生呼衰分为两个观察组,对患者详细资料的34个项目观察分析,观察数据进行统计学处理。用logistic回归分析筛选出导致术后呼衰的术前危险因素,并对其参数估计值进行标准化处理,以评价FOT在预测术后呼衰的临床价值。结果34个观察项目中,有21项提示与术后呼衰有密切关系。根据二项logistic回归筛选,只有8个因素作为术后呼衰的危险因素被筛选出。FOT检查中的5 Hz时的阻抗＼即弹性阻力(X_5)预测呼衰的灵敏度、特异度及准确率与第1秒用力呼气量(FEV1)相接近,而20 Hz时的黏性阻力占预计值百分比(R_(20)%)与最大通气量的实测值占预计值百分比(MVV%)相接近。结论强迫振荡肺功能(FOT)检查在预测术后呼衰方面与常规肺通气功能一样具有同等重要地位,甚至优于部分传统指标。
Objective To analyze the clinical value of preoperative pulmonary function and forced oscillation pulmonary function (FOT) in predicting postoperative respiratory failure. Methods 473 cases of lung resection patients underwent routine pulmonary function tests except for routine pulmonary function tests were forced to oscillate pulmonary function tests were divided into two observation group whether the onset of respiratory failure, the details of the patient 34 items of observation and analysis, observation data Statistical analysis. Logistic regression analysis was used to screen preoperative risk factors that led to postoperative respiratory failure and to standardize the estimation of parameters to evaluate the clinical value of FOT in predicting postoperative respiratory failure. Results Among the 34 observation items, 21 items were closely related to postoperative respiratory failure. According to the binomial logistic regression screening, only 8 factors were screened out as risk factors for respiratory failure. The sensitivity, specificity, and accuracy of the impedance at 5 Hz at FOT (ie, elastic resistance (X_5)) predicted FEV1 were similar to those at FEV1, whereas viscous resistance at 20 Hz The predicted percentage (R_ (20)%) is close to the predicted maximum ventilation percentage (MVV%). Conclusion Forced oscillatory lung function (FOT) examination is as important as routine pulmonary ventilation in predicting postoperative respiratory failure, even better than some traditional indicators.