60岁以上老年患者肺切除术后并发房颤的危险因素分析  

Risk Factors Analysis of Atrial Fibrillation after Lung Resection in Patients Aged 60 Years or Older

作　　者：王煜东[1] 李玉[2] 张苏宁[1] 赵俊刚[1] 鲁继斌[1] 

机构地区：[1]中国医科大学附属盛京医院胸外科,沈阳110004 [2]中国医科大学附属第一医院胸外科,沈阳110001

出　　处：《中国医科大学学报》2014年第7期635-638,650,共5页Journal of China Medical University

摘　　要：目的 探讨60岁以上老年患者肺切除术后并发房颤的危险因素,为防治肺切除术后房颤提供科学依据.方法 回顾性分析362例患者的临床资料.采用病例对照研究方法比较各因素对房颤组与非房颤组的影响差异,进行单因素及多因素Logistic回归分析.结果 362例患者中有52例术后并发房颤,发生率为14.36％.术后前3d发生房颤数占总发生数94.2％.单因素及多因素Logistic回归分析结果显示：60岁以上老年患者肺切除术后房颤与冠心病史、切除范围、手术入路、心包内操作相关（P＜0.05）.结论 60岁以上老年患者肺切除术后发生房颤的高峰时间为术后1～3 d.其中70岁以下与70岁以上2组术后房颤发生率及高峰分布均无明显差别.60岁以上老年患者肺切除术后房颤发生率与冠心病史、切除范围、手术入路、心包内操作相关（P＜0.05）.术前适当干预,术中小心操作可减少术后房颤的发生.Objective To explore the risk factors of atrial fibrillation after lung resection in patients aged 60 years or older and search for the prophylaxis of atrial fibrillation.Methods A retrospective analysis of 362 patients was performed by case control study,using univariate and multivariate Logistic regression analysis.Results Atrial fibrillation was documented in 52 patients with an incidence rate of 14.36％.The occurrence of postoperative atrial fibrillation occurred in the first three days was 94.2％.The result of both univariate and multivariate Logistic regression analysis showed that the main risk factors of atrial fibrillation after lung resection were history of coronary heart disease,extent of resection,laterality of procedure,and pericardial operation （P ＜ 0.05）.Conclusion The peak time of atrial fibrillation is 1-3 days after lung resection.There was no significant difference in age distribution or peak time of atrial fibrillation between the two sub-group of 60-70 years old and over 70 years old.The main risk factors of atrial fibrillation after lung resection were history of coronary heart disease,extent of resection,laterality of procedure,and pericardial operation （P ＜ 0.05）.The incidence of postoperative atrial fibrillation can be reduced by preoperative intervention and careful operation.

关 键 词：老年患者 肺切除术 房颤 危险因素 

分 类 号：R655.3[医药卫生—外科学]