肺癌围手术期死亡的高危因素分析  

High Risk Factors of Perioperative Death in Patients with Lung Cancer.

作　　者：龙荣尊[1] 罗德源[1] 黄森龙 姜月平[1] 陈种[1] 万仁平[1] 

机构地区：[1]广东省粤北人民医院心胸外科,广东省韶关市512026

出　　处：《中国综合临床》2007年第4期330-332,共3页Clinical Medicine of China

摘　　要：目的 探讨引起肺癌手术死亡的高危因素，进一步降低肺癌手术的病死率。方法 回顾性总结手术切除的2439例肺癌患者的临床资料，对其中76例围手术期死亡患者的临床及病理资料进行单因素和Cox（多因素时间-常数回归模型）回归分析。结果 单因素分析影响肺癌手术死亡的主要因素为术后并发症、术前合并心肺疾病、高龄、手术切除范围（P〈0．01），临床病理分期、癌残留情况（P〈0．05）。多因素分析影响肺癌手术死亡的独立危险因素为术后并发症、合并心肺疾病、高龄、手术切除范围、临床病理分期、癌肿残留。结论 术后并发症、严重肺功能不全、心功能不全及高龄是肺癌手术死亡的主要原因，患侧全肺切除、病理分期晚期及癌肿残留也是肺癌术后死亡的重要原因。Objective To explore the high risk factors of perioperative death in surgical patients with lung cancer in order to decrease the fatality. Methods The clinical data of 2439 eases of lung cancer treated surgically were retrospectively analyzed. The chi-spuare tests （ X2 ） and cox regression model were used to analyze the pathological and clinical data of 76 cases of perioperative death. Results Some risk factors were found such as postoperative complication, complicating cardiopulmonary disease, age, operative modality, residual lung cancer tissue as well as pathological staging（P 〈 0.01 and P 〈 0.05 ）. Multivariate analysis revealed that the postoperative complication, complicating cardlopulmonary disease, gerontism, operative modality, residual cancer tissue and pathologicla staging were independent factors for perioperative death. Conclusion The postoperative complication, serious pulmonary function failure,cardiac insufficiency, and gerontism are the main risk factors of perioperative death for lung cancer and pneumonectomy, residual cancer tissue as well as pathological staging are the important causes.

关 键 词：肺癌 外科手术 围术期死亡 高危因素 

分 类 号：R734[医药卫生—肿瘤]