| Objective Pulmonary function test(PFT)is a routine non-invasive examination for patients before surgery.It is usually used as a tool to assess the risk of surgery for patients.It has been believed to have predictive value for the occurrence of postoperative pulmonary complications(PPCs).The analysis of its risk factors may help to identify patients with higher risk of pulmonary complications after surgery.Through cohort study,this study explored whether the results of preoperative pulmonary function examination were correlated with the occurrence of PPCs in patients after surgery,and screened out its risk indicators,and then analyzed the risk factors of PPCs through clinical data to provide reference for reducing its incidence and improving the prognosis.Methods A retrospective study was performed on patients undergoing non-cardiac surgery under general anesthesia from 2018 to 2019.The patients were divided into two groups according to whether there were postoperative pulmonary complications: statistical gender,age,smoking history,ASA classification,whether there were chronic pulmonary diseases(including chronic obstructive pulmonary disease,chronic bronchitis,asthma,bronchiectasis,etc.),whether there were respiratory tract infections,other system complications(including hypertension,diabetes,heart disease,cerebral infarction),Operation type(abdominal surgery,chest surgery,urinary surgery,other surgery),operation time,operation grade,bleeding volume,anesthesia method(tracheal intubation,bronchial intubation,laryngeal mask general anesthesia),operation position(supine position,left lying position,right lying position,lithotomy position,other),smoking history(>10 years),postoperative hospitalization days,Grade of pulmonary dysfunction(normal,mild,moderate and severe),preoperative parameters of pulmonary function(FEV1%-pred,FEV1/FVC%,PEF%-pred,VC%-pred,TLC%-pred,RV%-pred,FRC%-pred,DLCO%-pred).The measurement data conforming to the normal distribution are expressed as mean ±standard deviation(x ± s),and the ANOVA and independent sample t-test are used for inter-group comparison;The measurement data that do not conform to the normal distribution are expressed in M(p25,p75),and compared between the two groups using Mann-Whitney U test;The classification data were expressed in examples(%),and Pearson’s chi-squared test or Fisher’s exact probability method was used for comparison between groups.The collected data were analyzed by single factor analysis,and the relevant risk factors were screened out,and multi-factor logistic regression analysis was performed.Results 1.The lung function indexes collected in patients with normal lung function and mild impairment had no statistical significance on the incidence of PPCs.In patients with moderate and severe impairment of lung function,only DLCO%-pred had statistical significance.(P>0.05)。2.9The total incidence of PPCs in the 06 patients was 9.6%.In the univariate analysis,the PPCs group and the non-PPCs group had statistical significance in smoking history(>10 years),age,chronic lung disease,preoperative respiratory infection,ASA grade,operation type,operation time,operation grade,anesthesia method,bleeding volume,and postoperative hospitalization days(P<0.05).The results of binary logistic regression showed that age,smoking history(>10 years)and chronic lung disease were independent risk factors for PPCs(P<0.05).Conclusion Preoperative PFT can effectively detect the abnormalities of lung function.In this study,DLCO%-pred can predict the occurrence of postoperative pulmonary complications in patients with moderate and severe abnormalities of lung function,and is not limited to the type of surgery.Age,smoking history(>10years)and chronic lung disease are independent risk factors for PPCs.Active preoperative treatment of complications and improvement of cardiopulmonary function will help to reduce the occurrence of postoperative pulmonary complications. |
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