胸腔镜治疗老年早期肺癌围术期心肺并发症危险因素分析  

Perioperative complications and risk factors analysis of thoracoscope treatment for the elderly early lung cancer

作　　者：李震宇[1] 张磊冰[1] 王俊[1] 赵勇[1] 罗蕾[1] 范伟[1] 

机构地区：[1]贵州省人民医院急诊外科,贵阳550002

出　　处：《重庆医学》2016年第22期3055-3056,3059,共3页Chongqing medicine

基　　金：贵州省科技厅黔科合(LH字[2015]7132号);贵阳市科技计划项目(筑科合同[20151001]社65号)

摘　　要：目的分析胸腔镜手术治疗老年早期肺癌围术期并发症的主要危险因素，为老年肺癌并发症的防治提供科学依据。方法回顾性分析2008-2014年该院行胸腔镜手术切除的100例老年早期肺癌患者的临床资料。对围术期发生肺部感染、心律失常、胸腔积液、气胸等心肺并发症的危险因素分别行单因素y。检验及多因素Logistic回归分析。结果100例病例中24例（24％）发生心肺并发症。单因素分析结果显示：年龄大于70岁、吸烟指数大于400、1秒钟用力呼气量与用力肺活量比值（FEV1％）≤60％、手术时间大于3h和合并基础疾病5个危险因素显著影响老年早期肺癌围术期心肺并发症发生率（P〈0．05），性别、手术方式、肿瘤类型3个危险因素无显著影响（P〉0．05）。多因素Logistic回归分析结果显示：吸烟指数大于400、手术时间大于3h是老年早期肺癌围术期心肺并发症发生的影响因素。结论术前全面评估上述危险因素，可初步预测围术期心肺并发症的发生率。Objective To explore the main risk factors of perioperative complications of thoracic surgery in elderly patients with early lung cancer,and to provide scientific evidence for prevention and treatment of lung cancer complications. Methods Retrospective analysis of the clinical data of 1O0 cases of elderly patients with early lung cancer in our hospital from January 2008 to December 2014. The risk factors of pulmonary infection, arrhythmia, pleural effusion, pneumothorax and other cardiac and pulmonary complications occurred during the perioperative period were analyzed by univariate Z2 test and multivariate logistic regression. Results Among 100 elderly early lung cancer patient.s,the perioperative cardiopulmonary complications occurred in 24 cases with a complication rate of 24% . The results of the univariate x2 showed that patients aged over 70 years, smoking index〉400,FEV1% ≤ 60% , operative time over 3 hours,and patients with underlying diseases were more likely get perioperative cardiopulmonary complications（P〈0.05）. There was no significant effect of 3 risk factors on the incidence of perioperative cardiopulmonary complications in elderly patients with lung cancer（P〉0.05）. Multivariate logistic regression analysis showed that smoking index〉400,operative time over 3 hours were risk factors of perioperative cardiopulmonary complications in elderly early lung cancer（P〈0. 05）. Conclusion Patients aged over 70 years, smoking index〉400, FEV1% ≤ 60% , operative time over 3 hours, and patients with underlying diseases,were main factors that influenced the occurrence of perioperative cardiopulmonary complications after the thoracoscope surgery. Acomprehensive assessment of the risk factors for elder early lung cancer patients before surgery, can help predict patients＇preliminary perioperative cardiopulmonary complications.

关 键 词：胸腔镜 早期肺肿瘤 围术期并发症 危险因素 

分 类 号：R734.2[医药卫生—肿瘤]