全腔镜下老年食管癌根治术后肺部并发症相关因素研究  

Risk factors correlated to postoperative pulmonary complications after laparoscopy and thoracoscopy for esophagus cancer in senile patients

作　　者：田静静[1] 李娇丽[2] 李玮浩[2] 

机构地区：[1]郑州大学第一附属医院手术部,450052 [2]郑州大学第一附属医院胸外科,450052

出　　处：《中华实验外科杂志》2015年第11期2851-2853,共3页Chinese Journal of Experimental Surgery

摘　　要：目的 探讨70岁以上老年食管癌患者全腔镜手术切除后影响肺部并发症的相关因素.方法 统计在我院接受全腔镜手术治疗的360例70岁以上老年食管癌患者的年龄、性别、吸烟指数、手术时间、学习曲线、合并内科疾病、病理分期和喉返神经损伤等临床资料,分析可能影响术后肺部并发症的相关因素.结果 本组患者围手术期死亡率为0.28％ （1/360）.术后肺部并发症发生率为5.83％ （21/360）,包括肺部感染、肺不张、脓胸、呼吸衰竭等.术后影响肺部并发症的相关因素包括年龄（x2=3.941,P＜0.05）、吸烟指数（x2=6.225,P＜0.05）、手术时间（x2=4.312,P＜0.05）、学习曲线（x2=6.372,P＜0.05）、两种及以上内科合并症（x2=4.251,P＜0.05）和术后喉返神经损伤（x2 =49.015,P＜0.01）.结论 影响全腔镜下食管癌根治术围手术期肺部并发症的相关因素包括年龄、吸烟指数、手术时间、学习曲线、两种及以上内科合并症和术后喉返神经损伤.Objective To investigate the pulmonary complications and their influencing factors after thoracolaparoscopic esophagectomy in over 70-years-old patients with lung cancer.Methods A total of 360 patients over 70 years old diagnosed with esophageal cancer in our hospital were treated with thoracolaparoscopic esophagectomy.Clinical data of age, smoking index, operative time, learning curve, two or more medical complications, and postoperative recurrent laryngeal nerve injury were analyzed.The related factors influencing the postoperative pulmonary complications were also analyzed.Results The perioperatire mortality rate was 0.28% （1/360）.Postoperative pulmonary complication rate was 5.83% （21/360）, including pulmonary infection, atelectasis, empyema, respiratory failure.Postoperative pulmonary complications-related factors included age （x2 =3.941, P 〈 0.05）, smoking index （x2 =6.225, P 〈 0.05）, operative time （x2 =4.312, P 〈 0.05）, the learning curve （x2 =6.372, P 〈 0.05）, two or more medical complications （x2 =4.251, P 〈 0.05） , and postoperative recurrent laryngeal nerve injury （x2 =49.015, P 〈 0.01）.Conclusion The perioperative pulmonary complications-related factors included age, smoking index, operative time, the learning curve, the two or more complicated medical diseases, and postoperative recurrent laryngeal nerve injury.

关 键 词：全腔镜 食管癌 肺部并发症 外科技术 

分 类 号：R734.2[医药卫生—肿瘤]