Study On Preoperative Pulmonary Founction In Lung Cancer Patients With Bronchial Obstruction

Objectives:Through the study on the changes of preoperative pulmonary function in the lung cancer patients with bronchial obstruction by cancer, we tried to find the factors that may affect the preoperative lung function and the shortages of methods for predicting postoperative lung function in past years. The possible effective way to coliberate assessment of preoperative lung function and the prediction of postoperative lung function in those patients are discussed and proposed.Methods:The relationship between the parameters of preoperative lung function with the possible factors affecting these parameters in 406 lung cancer patients examined by fiberobronchoscopy were analyzed using multiple linear regression analysis. Of the 406 patients,132 were selected and divide into four groups according to bronchial obstruction under FOB inspection:none (33 cases), segmental bonchus (33 cases) lobe bronchus (33 cases) and main bronchus (33 cases) with age and sex matched in each group. The difference in the parameters of preoperative lung function of each group were compared, including actual observed value and the percentage of actual observed value to predicted value of VC, FVC, FEV1, FEV1/FVC, MVV and DLCO.Results:The results of multiple linear regression analysis on the preoperative pulmonary function in the 406 lung cancer patients showed that preoperative pulmonary function was mainly affected by sex, age and the number of obstructed lung segments. Analysis of variance of the parameters of preoperative pulmonary lung function among the above four groups showed that the occurrence of atelectasis or pulmonary consolidation detected by X-ray imaging increased with the level ascendance of bronchial obstruction. The differences in all parameters except FEV1/FVC among groups were significant (p<0.05). Furthermore, the measured valve of all parameters except FEV1/FVC decrease with the ascendance of bronchial obstruction level:segmental bronchus group> lobe bronchus group> main bronchus group.Conclusion:The incidence of atelectasis or consolidation of lung tissue increases with the ascendance of bronchial obstruction level in lung cancer patients, the higher the bronchial obstruction level is. the worse pulmonary function is observed. Therefore, the restrictive effect caused by obstruction may play a more important role in the impairment of preoperative pulmonary function. In the past years, postoperative pulmonary function may be underestimated based on the impaired preoperative pulmonary function in the lung cancer patients with a lobe or main bronchus obstruction, thus, it should be calibrated in a suitable way in order to properly widen the indications of lung resection for these patients.