双源CT定量成像技术对肺癌患者术后肺功能改变的应用价值
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摘要
目的研究双源CT定量成像技术对肺癌患者术后肺功能改变的临床应用价值。方法以2015年2月-2018年2月在我院接受单操作孔胸腔镜下肺叶或全肺切除治疗的肺癌患者132例为观察对象。术前7d以及术后3个月对所有患者进行常规肺功能检测,同时采用双源CT定量成像技术对患者进行扫描,分别测量患者不同肺叶、单侧肺以及全肺的肺容积以及肺密度值等指标水平。分析双源CT定量成像技术扫描所获得的肺容积水平和患者术前、术后肺功能指标的相关性。此外,分析术前CT肺功能预测值和术后肺功能实测值的相关性。结果右中叶、右上叶、右下叶、左下叶、左上叶的吸气容积呈逐渐升高趋势,且经单因素方差分析可得:各肺叶之间对比差异均有统计学意义(均P<0.05)。吸气相容积、呼气相容积、肺容积差、吸气相肺密度、呼气相肺密度、肺密度差与患者手术前后的肺总量、残气量、FVC、FEV_1、FEV_1/FVC均存在密切相关(均P<0.05)。不同手术部位术前CT肺功能预测值和术后肺功能实测值具有较高的相关性,且相关系数最高为0.95。结论双源CT定量成像技术应用于肺癌患者术后肺功能改变中的效果较佳,有利于精确评估肺癌患者接受手术治疗后的肺功能变化状况,值得临床推广应用。
Objective To study the clinical application value of dual-source CT quantitative imaging technology in postoperative pulmonary function changes of lung cancer patients. Methods From February 2015 to February 2018, 132 cases of lung cancer treated with single operation hole thoracoscopic lobectomy or pneumonectomy were observed. The preoperative 7 d and 3 months after the operation were used for routine pulmonary function test, and the patients were scanned by dual source CT quantitative imaging technique, and the lung volume and lung density of the patients were measured in different lung, unilateral lung and lung. The correlation between lung volume obtained by dual source CT quantitative imaging and preoperative and postoperative pulmonary function was analyzed. In addition, the correlation between preoperative CT lung function and postoperative lung function was analyzed. Results The inspiratory capacity of right middle and upper leaves and lower leaves, left lower lobe, and left upper lobe showed a trend of increasing gradually, and it showed significant difference between any two sites(P<0.05). Inspiratory phase volume,poor lung volume,inspiratory and expiratory phase volume phase lung density,expiratory phase lung density,lung density difference with before and after surgery in patients with lung volume,residual volume,FVC,FEV1,FEV1/FVC were very closely related( all P < 0. 05). There was a high correlation between preoperative CT lung function prediction and postoperative lung function measurement at different surgical sites,and the maximum value of correlation coefficient was 0. 95. Conclusion The application of dual source CT imaging technique in lung cancer patients with postoperative pulmonary function changes is better,which is helpful for accurate assessment of lung function changes after surgical treatment of lung cancer patients.
Objective To study the clinical application value of dual-source CT quantitative imaging technology in postoperative pulmonary function changes of lung cancer patients. Methods From February 2015 to February 2018, 132 cases of lung cancer treated with single operation hole thoracoscopic lobectomy or pneumonectomy were observed. The preoperative 7 d and 3 months after the operation were used for routine pulmonary function test, and the patients were scanned by dual source CT quantitative imaging technique, and the lung volume and lung density of the patients were measured in different lung, unilateral lung and lung. The correlation between lung volume obtained by dual source CT quantitative imaging and preoperative and postoperative pulmonary function was analyzed. In addition, the correlation between preoperative CT lung function and postoperative lung function was analyzed. Results The inspiratory capacity of right middle and upper leaves and lower leaves, left lower lobe, and left upper lobe showed a trend of increasing gradually, and it showed significant difference between any two sites(P<0.05). Inspiratory phase volume,poor lung volume,inspiratory and expiratory phase volume phase lung density,expiratory phase lung density,lung density difference with before and after surgery in patients with lung volume,residual volume,FVC,FEV1,FEV1/FVC were very closely related( all P < 0. 05). There was a high correlation between preoperative CT lung function prediction and postoperative lung function measurement at different surgical sites,and the maximum value of correlation coefficient was 0. 95. Conclusion The application of dual source CT imaging technique in lung cancer patients with postoperative pulmonary function changes is better,which is helpful for accurate assessment of lung function changes after surgical treatment of lung cancer patients.
引文
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[9] 苏瑞雪,李玉兰,潘道刚,等.单肺通气中肺损伤及肺复张策略[J].临床肺科杂志,2015,20(10):1876-1879.
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[11] 黄梅萍,黄拔威,王洁,等.双源CT肺容积测定在支气管哮喘患者支气管舒张试验中的应用价值[J].中国继续医学教育,2017,9(4):93-96.
[12] 张墨洁,常晓悦.双源CT?DEPI在慢性肺源性心脏病合并肺小动脉血栓形成中的临床应用价值[J].医学综述,2013,19(7):1301-1303.
[13] 付蓉,李一鸣,李澄.慢性阻塞性肺疾病合并肺癌的多层螺旋CT研究进展[J].国际医学放射学杂志,2018,41(1):50-53.
[14] 李敏,梁朝阳,郭俊唐,等.双源CT定量容积成像技术预测肺癌患者术后肺功能改变的前瞻性研究[J].中华外科杂志,2014,52(10):734-738.
[15] 顾亚律,陆信,凌锋,等.MSCT对肺减容术肺形态及功能预测的临床应用研究[J].中国CT和MRI杂志,2015,13(4):27-29.
[2] 靳艳辉.心肺功能综合评估对肺癌患者手术预后评价的价值[J].实用癌症杂志,2017,32(2):299-301,304.
[3] 姜艳平,赵云峰,赵秋良.CT对慢性阻塞性肺疾病临床评估的价值[J].临床肺科杂志,2014,19(9):1684-1686.
[4] 赵峥,杨晓光,苏春勇,等.单光子发射计算机体层扫描对围手术期肺癌患者心肺功能的诊断价值研究[J].中国医学装备,2017,14(10):61-64.
[5] 蒋虹,李隽,童皖宁,等.肺功能指数对肺癌胸腔镜术后患者肺部感染的影响[J].中国临床医生杂志,2018,46(5):576-578.
[6] 张洪斌,陆超,梁正.双源CT容积测定评估肺癌患者肺功能的应用[J].中国现代医学杂志,2017,27(27):82-85.
[7] 王俊义,张鹏,刘毅梅,等.6分钟步行试验与运动心肺功能测定预测肺癌患者术后并发症的价值[J].天津医科大学学报,2013,19(2):137-139.
[8] 于海文,徐东楚,刘永健,等.呼吸锻炼对肺癌术后患者肺功能和生活质量的影响[J].实用临床医学,2018,19(2):31-34,46.
[9] 苏瑞雪,李玉兰,潘道刚,等.单肺通气中肺损伤及肺复张策略[J].临床肺科杂志,2015,20(10):1876-1879.
[10] 王领会,周雯,赵华,等.双源CT定量容积成像技术在肺癌患者术后护理中的作用[J].护理实践与研究,2016,13(15):78-79.
[11] 黄梅萍,黄拔威,王洁,等.双源CT肺容积测定在支气管哮喘患者支气管舒张试验中的应用价值[J].中国继续医学教育,2017,9(4):93-96.
[12] 张墨洁,常晓悦.双源CT?DEPI在慢性肺源性心脏病合并肺小动脉血栓形成中的临床应用价值[J].医学综述,2013,19(7):1301-1303.
[13] 付蓉,李一鸣,李澄.慢性阻塞性肺疾病合并肺癌的多层螺旋CT研究进展[J].国际医学放射学杂志,2018,41(1):50-53.
[14] 李敏,梁朝阳,郭俊唐,等.双源CT定量容积成像技术预测肺癌患者术后肺功能改变的前瞻性研究[J].中华外科杂志,2014,52(10):734-738.
[15] 顾亚律,陆信,凌锋,等.MSCT对肺减容术肺形态及功能预测的临床应用研究[J].中国CT和MRI杂志,2015,13(4):27-29.