文章摘要
程少毅,陈 召,陈 静,卢 强,周勇安,杨三虎.胸腔镜下肺叶切除术后发生肺部并发症的危险因素分析[J].,2019,19(6):1087-1090
胸腔镜下肺叶切除术后发生肺部并发症的危险因素分析
Analysis of Risk Factors of Postoperative Pulmonary Complications in Patients Undergoing Thoracoscopic Lobectomy
投稿时间:2018-09-15  修订日期:2018-10-11
DOI:10.13241/j.cnki.pmb.2019.06.018
中文关键词: 胸腔镜  肺部并发症  危险因素
英文关键词: Thoracoscopic surgery  Pulmonary complications  Risk factors
基金项目:国家自然科学基金项目(81572252)
作者单位E-mail
程少毅 空军军医大学唐都医院胸外科 陕西 西安 710032 15877323778@163.com 
陈 召 解放军第四五六医院 山东 济南 250033  
陈 静 泰州职业技术学院护理系 江苏 泰州 225300  
卢 强 空军军医大学唐都医院胸外科 陕西 西安 710032  
周勇安 空军军医大学唐都医院胸外科 陕西 西安 710032  
杨三虎 空军军医大学唐都医院胸外科 陕西 西安 710032  
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中文摘要:
      摘要 目的:探讨胸腔镜下肺叶切除术后发生肺部并发症的危险因素。方法:连续收集从2015年1月至2017年6月份我科收治的因肺癌行胸腔镜下肺叶切除的患者,收集患者的基本资料,包括性别、年龄、一秒用气呼气容积百分比(Percentage predicted forced expiratory volume in 1 s,FEV1%)、美国麻醉医师协会评分(American Society of Anesthesiologists,ASA)、BMI指数、慢性阻塞性肺疾病(Chronic obstructive pulmonary disease,COPD)和肿瘤的发生情况。统计患者的术后住院时间、ICU停留时间和住院死亡率,收集患者术后肺部并发症的发生情况、术后第一天活动和是否需要理疗。对比分析发生肺部并发症和不发生并发症患者的差异,对有差异的因素利用Logistic回归分析发生肺部并发症的独立危险因素。结果:根据纳入排除标准,共有256例患者纳入研究,其中男性126例,平均年龄为67.2±13.7岁,术后共有19例(7.4%)患者发生肺部并发症。发生并发症的患者较未发生并发症的患者术后住院时间长、ICU停留时间长、死亡率高(P<0.05)。发生并发症的患者术后下地活动情况差。两组患者的年龄、COPD和吸烟情况有统计学差异(P<0.05),Logistic回归分析显示吸烟是术后发生肺部并发症的独立危险因素。结论:胸腔镜下肺叶切除患者术后肺部并发症增加术后死亡率,吸烟是患者术后发生肺部并发症的独立危险因素。
英文摘要:
      ABSTRACT Objective: To investigate the risk factors of pulmonary complications after thoracoscopic lobectomy. Methods: Consecutive patients who underwent thoracoscopic lobectomy in our department for lung cancer from January 2015 to June 2017 were collected. Patients' basic informations, including gender, age, percentage of expiratory volume of the first second (FEV1%), American Society of Anesthesiologists scores (ASA), BMI index, Chronic obstructive pulmonary disease (COPD) incidence and tumor status, were reviewed. The postoperative hospital stay, ICU stay time, and hospital mortality were counted, and the postoperative pulmonary complications, postoperative first day activities, and physiotherapy were recorded. The differences between patients with pulmonary complications and non-complication were comparatively analyzed, and Logistic regression was used to analyze the independent risk factors for pulmonary complications among the differential factors. Results: According to the exclusion criteria, a total of 256 patients were included in the study, including 126 males, and the average age was 67.2 ±13.7 years. A total of 19 patients (7.4%) developed pulmonary complications. Patients with pulmonary complications had longer postoperative hospital stay, longer ICU stay, and higher mortality (P<0.05). Patients with pulmonary complications have poor postoperative activity. There were significant differences in age, COPD, and smoking between the two groups (P<0.05), but logistic regression analysis found that smoking was an independent risk factor for postoperative pulmonary complications. Conclusion: Postoperative pulmonary complications in patients undergoing thoracoscopic lobectomy have increased postoperative mortality, and smoking is an independent risk factor for postoperative pulmonary complications in patients.
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