Left Pneumonectomy Cardiopulmonary Complications After Lung Cancer With Preoperative Pulmonary Function Index Detection And Correlation Analysis

Objective: At present, the clinical operation after resection of lung cancer, cardiac and pulmonary complications(postoperative cardiopulmonary complication, PCC) of the disease incidence rate is high, these complications, even endangering the lives of patients, the light will influence the life quality of the patients. Therefore, to prevent postoperative complications after lung cancer surgery has important significance in clinical treatment of lung cancer operation. If I can pass on lung cancer patients with preoperative pulmonary function and impulse oscillometry(IOS) detection,assessment, prediction of postoperative complications, can pass through the adjustment of operation planning and intraoperative, postoperative medication,strengthen the nursing in peri operation period, reduce the occurrence of postoperative cardiopulmonary complications to. Therefore, this study analyzed the preoperative pulmonary function indexes and postoperative complication correlation, proposed by lung cancer patients preoperative pulmonary function and impulse oscillometry(IOS)risk of detection index assessment, prediction of postoperative complications.Methods:(1) We collected from 2008 January to 2010 December, clinical data of 200 patients underwent left pneumonectomy in patients with lung cancer, according to the postoperative patients in January whether the occurrence of complications of lung and heart were divided into PCC group and non PCC group, analysis of preoperative normal, mild, moderate and severe pulmonary function to reduce the impact on the occurrence of postoperative complications.(2)Collect the clinical data of patients with lung cancer in 2012 January to 2012 December underwent left pneumonectomy in100 cases, the postoperative complications of 50 cases of respiratory failure, 50 cases of complications did not appear. Comparison of respiratory failure and respiratory failure appeared difference in patients with preoperative IOS index detection; the differences of central type lung cancer and peripheral lung cancer by preoperative IOS index detection.(3) In 200 cases of lung cancer patients FEV1%, MVV% parameters according to each parameter and the ratio of 3:1 in 50 cases of lung cancer patients with IOS according to the proportion of 4:1, the application of BP neural network method on postoperative complications for modeling and prediction.Results:(1)In 200 cases of normal, mild, moderate and severe pulmonary function to reduce each 35, 45, 98, 22 cases, after January the incidence rate of PCC were 28.6%,53.3%, 60.2%, 77.3%, compared with the normal group, the difference was statistically significant(P<0.05). Further analysis showed that: when the FEV1% or MVV% alone in patients with mild decrease, the incidence of postoperative PCC were 40%, 35.29%, compared with the normal group, no significant difference(P >0.05); while FEV1% and MVV% also slightly reduced, the incidence of PCC was78.57%, the difference was significant(with P<0.01). When the FEV1% or MVV%alone, and moderate decrease in patients after surgery, the incidence of PCC was52.63%, 55.55%, 69.04%,, compared with the normal, the difference was statistically significant(P < 0.05); when the FEV1% or MVV% alone and severe degreedecreased, because of the small sample size, unable to make statistical analysis; when FEV1% and MVV% at the same time, severe decrease, the incidence of PCC was89.47%, compared with the normal, the difference was very significant(P<0.01).(2)Respiratory failure group and non respiratory failure group preoperative IOS indexes were significantly different(P<0.05); comparison of central type lung cancer group and the peripheral lung cancer group, except R20 had no significant difference, the other indexes have significant difference.(3) 200 patients with FEV1%, the model established by MVV%, the fitting rate is 94.37%, the prediction accuracy is more than90%, the average error is 0.023; 50 cases of the establishment of the model parameters of patients with IOS, the fitting rate is 99.73%, the prediction accuracy is more than 90%, the average error is 0.020.Conclusion:(1) Preoperative pulmonary function status directly influence the occurrence of postoperative complications, the decline of lung function were risk factors for postoperative complications. With the further decline of lung function, the complication rate is on the rise, decline in the group compared with control group, P <0.05, and the difference increased. MVV% FEV1%, a separate slightly reduced compared with the normal group, no significant effect on the incidence of complications, when FEV1% and MVV% also slightly reduced are risk factors for PCC lung cancer of the left after hysterectomy, should strengthen the management of peri operation period, reduce the incidence of PCC. MVV% FEV1%, one of moderate or severe reduction, will influence the occurrence of postoperative complications, if both at the same time reduce postoperative complications occurred, is more likely to.So preoperative FEV1%, MVV% reduced the detection index of pulmonary ventilation function is affected the risk of lung cancer left pneumonectomy complication of post, and reduce the degree of the greater risk of complications is higher.(2) The risk of respiratory failure complication of lung cancer preoperative respiratory impedance IOS detection indicators can help to assess left after pneumonectomy, indications for operation evaluation plays an important role in.(3)In this study, predict the occurrence of postoperative complications of BP neural network to establish the pulmonary ventilation function and impulse oscillometry lung function parameters is feasible, but due to the limited sample size, further research on its application.