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Abstract：
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality and is significantly underdiagnosed in the community. Respiratory impairment is a key risk factor for perioperative morbidity and mortality. The National Institute for Health and Care Excellence (NICE) does not recommend routine spirometry before major surgery. However, in this article, we present the potential benefits of targeted spirometry in high-risk patient groups. Of 183 patients who underwent targeted preoperative spirometry, 25/70 (35.7%) of those with airflow obstruction had no previously known respiratory diagnosis. Of patients with known COPD, 20/46 (43.5%) were not prescribed optimum inhaled therapies for their degree of lung function deficit. Knowledge of lung function in respiratory disease helps to optimise patients perioperatively and facilitate shared decision making regarding the benefits and risk of surgeries. We propose that targeted spirometry should be used as part of the perioperative multidisciplinary team assessment of selected patients.
摘要：
慢性阻塞性肺疾病（COPD）是发病率和死亡率的主要原因，在社区中被严重低估。呼吸损害是围手术期发病率和死亡率的关键危险因素。美国国家健康与护理卓越研究所（NICE）不建议在大手术前进行常规肺活量测定。然而,在这篇文章中,我们介绍了有针对性的肺活量测定在高危患者组中的潜在益处.在183例接受有针对性的术前肺活量测定的患者中，25/70（35.7％）的气流阻塞患者没有先前已知的呼吸道诊断。在已知COPD的患者中，20/46（43.5％）的肺功能缺陷程度未规定最佳吸入疗法。了解呼吸系统疾病的肺功能有助于优化围手术期患者，并促进有关手术益处和风险的共同决策。我们建议将有针对性的肺活量测定法用作对选定患者进行围手术期多学科小组评估的一部分。
