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目的:分析探讨术前肺功能低下、MVV≤40%肺癌患者的手术指征。方法:本组31例术前均进行了以下检查:(1)肺通气功能,指标包括FVC、FEV_1、MVV、FEF25～75%等。(2)动脉血气分析。(3)屏气试验。(4)上楼梯试验。(5)ECG。结果:本组FVC>60%24例,<60%7例,FEV_1>50%26例、<40%5例,MVV≤40%31例。术后并发肺炎6例,肺不张4例,肺水肿2例,均治愈。结论:在确定重度肺功能减退病人手术标准时,应将MVV、FEV_1、FVC放在一综合判定,FVC应在60%以上,MVV和FEV_1两项中至少有一项在40%以上。PaO_2>8kPa,PaCO_2<6kPa,同时还应结合患者的年龄、平时活动能力、屏气试验、运动试验、血气分析、ECG以及肺切除量等因素来综合分析判断。
Objective: To analyze the preoperative pulmonary function, MVV ≤ 40% of patients with lung cancer indications. Methods: All the 31 cases were examined preoperatively as follows: (1) Ventilatory function of lung, including FVC, FEV_1, MVV, FEF25 ~ 75%. (2) Arterial blood gas analysis. (3) breath test. (4) up the stairs test. (5) ECG. Results: There were 24 cases of FVC> 60%, 7 cases <60%, 26 cases of FEV1> 50%, 5 cases of <40% and 31 cases of MVV≤40%. Postoperative pneumonia in 6 cases, atelectasis in 4 cases, 2 cases of pulmonary edema, were cured. Conclusions: MVV, FEV_1 and FVC should be put in a comprehensive judgment in determining the surgical criteria for patients with severe pulmonary dysfunction. The FVC should be above 60% and at least one of MVV and FEV_1 should be above 40%. PaO_2> 8kPa, PaCO_2 <6kPa, combined with the patient’s age, usual mobility, breath holding test, exercise test, blood gas analysis, ECG and lung resection and other factors to comprehensive analysis and judgment.