心肺运动试验评估食管癌患者化疗前后整体功能变化的临床价值

发布时间：2019-08-24 12:51

【摘要】：目的探讨食管癌化疗前后心肺运动试验(CPET)评价患者整体功能变化的临床价值及食管癌化疗前后整体功能的变化。方法选取拟行化疗的食管癌患者60例,患者在化疗前和化疗结束后1 w时进行CPET检查并分析结果。结果患者化疗后峰值氧脉搏、峰值摄氧量、摄氧效率平台、峰值负荷功率较化疗前明显下降,CO_2通气当量斜率和最低值较化疗前上升,差异有统计学意义(P0.05),递增功率运动时间和无氧阈与化疗前比较无统计学意义(P0.05);静息状态下心率、极限状态下CO_2通气当量化疗后较化疗前明显上升(P0.05),极限状态下摄氧量、热身状态下平均动脉压化疗后较化疗前下降(P0.05),静息状态、热身状态、无氧阈状态、极限状态下氧脉搏与摄氧通气效率化疗后均较化疗前下降(P0.05);极限状态下每呼吸摄氧量、每呼吸CO_2排出量化疗后较化疗前明显下降(P0.05),静息状态、热身状态、无氧阈状态、极限状态下潮气量、分钟通气量、呼吸频率、呼吸交换比值化疗前后比较差异无统计学意义(P0.05)。结论化疗可引起患者整体功能的下降,主要是影响患者循环和细胞代谢功能,化疗后呼吸功能则处于相对代偿阶段,化疗前后采用PCET检查可客观评价患者整体功能的改变。
[Abstract]:Objective to investigate the clinical value of cardiopulmonary exercise test (CPET) in evaluating the overall function of patients with esophageal cancer before and after chemotherapy and the changes of overall function of esophageal carcinoma before and after chemotherapy. Methods 60 patients with esophageal cancer undergoing chemotherapy were examined by CPET before chemotherapy and 1 week after chemotherapy. Results the peak oxygen pulse, peak oxygen uptake, oxygen uptake efficiency platform and peak load power after chemotherapy were significantly lower than those before chemotherapy, and the CO_2 ventilation equivalent slope and minimum value were significantly higher than those before chemotherapy (P 0.05). There was no significant difference in incremental power exercise time and anoxic threshold between before chemotherapy and before chemotherapy (P 0.05). Heart rate in resting state, CO_2 ventilation equivalent after chemotherapy in limit state was significantly higher than that before chemotherapy (P 0.05), oxygen uptake in limit state and mean arterial pressure in warm-up state were lower than those before chemotherapy (P 0.05), resting state, warm-up state, anoxic threshold state, oxygen pulse and oxygen intake ventilation efficiency in limit state were lower than those before chemotherapy (P 0.05). There was no significant difference in oxygen uptake per breath and CO_2 excretion per breath between before and after chemotherapy (P 0.05). There was no significant difference in resting state, warm-up state, anoxic threshold state, tidal volume in limit state, minute ventilation volume, respiratory rate and respiratory exchange ratio before and after chemotherapy (P 0.05). Conclusion chemotherapy can cause the decrease of the overall function of the patients, mainly affecting the circulation and cell metabolism of the patients, while the respiratory function after chemotherapy is in the relative compensation stage. PCET examination before and after chemotherapy can objectively evaluate the changes of the overall function of the patients.
【作者单位】：江苏大学医学院;上海市青浦区中医医院消化内科;常州市金坛区第一人民医院消化内科;镇江市第一人民医院肿瘤科;上海市第一人民医院消化内科;
【分类号】：R735.1

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