食管癌患者术后肺部感染围手术期的影响因素分析  

Ridge regression analysis of pulmonary infection rate after transthoracic esophagectomy for esophageal cancer

作　　者：王丽君[1] 顾连兵[1] 蒋大明[1] 高蓉[1] 许仄平[1] 万梅方[1] 鲁振[1] 

机构地区：[1]江苏省肿瘤医院麻醉科,南京210009

出　　处：《中华医学杂志》2012年第19期1310-1313,共4页National Medical Journal of China

基　　金：江苏省自然科学基金（BK2010588）;江苏省肿瘤医院青年基金（ZQ200906）

摘　　要：目的从麻醉学角度探讨食管癌术后肺部感染的影响因素。方法采用回顾性调查的方法，收集江苏省肿瘤医院2009年1—12月349例食管癌根治术患者的临床资料，用多因素分析法分析患者术前生理指标、术中麻醉学参数、以及患者术后恢复情况等26个指标与食管癌术后肺部感染发生率之间的关系。结果349例患者术后的肺部感染发生率为27．8％，岭回归分析显示26个相关指标中有8个因素对肺部感染具有显著的影响，其作用大小依次为：术后硬膜外镇痛（PCEA）、糖尿病、术中复合硬膜外阻滞、其他术后并发症、单肺通气（OLV）、悬浮少白细胞红细胞输注量、体质指数（BMI）、年龄，其中，PCEA为术后肺部感染的抑制因素，其余均为促进因素。结论食管癌术后肺部感染的影响因素包括PCEA、糖尿病、术中复合硬膜外阻滞、其他术后并发症、OLV、悬浮少白细胞红细胞输沣茸、BMI、年龄。Objective To identify the influencing factors of pulmonary infections after transthoracic esophagectomy for esophageal cancer. Methods A retrospective review of 349 patients undergoing transthoracic esophagectomy at our hospital for esophageal cancer was performed between January and December 2009. The postoperative pneumonia rate was examined and 26 perioperative factors possibly affecting the postoperative respiratory complications were collected. Ridge regression modeling was performed to determine if a significant association existed between perioperative factors and postoperative pneumonia. Results The postoperative pneumonia rate of all patients was 27.8%. Eight perioperative factors were found to have affected significantly the postoperative respiratory complications. The influencing factors included （according to contribution） ：patient control epidural analgesia （PCEA）, diabetes, general anesthesia plus epidural analgesia, other postoperative complications, one lung ventilation （OLV）, transfusion volume of red blood ceils （RBC） , body mass index （BMI） and age. Conclusion The major influencing factors of pulmonary infection after transthoracic esophagectomy for esophageal cancer are PCEA, diabetes, general anesthesia plus epidural analgesia, other postoperative complications, OLV, transfusion volume of RBC, BMI and age.

关 键 词：食管癌 手术 肺部感染 岭回归 

分 类 号：R735.1[医药卫生—肿瘤]