食管癌术后并发心房颤动的危险因素分析  

Risk factors analysis of atrial fibrillation after radical esophagectomy

作　　者：汤隽[1] 赵健竹[1] 王希文[1] 赵俊刚[1] 无 TANG Jun;ZHAO Jianzhu;WANG Xiwen;ZHAO Jungang(Department of Thoracic Surgery, Shengjing Hospital, China Medical University, Shenyang, 110004, P.R. China;Department of Medical Oncology, Shengding Hospital, China Medical University, Shenyang, 110004, P.R.China)

机构地区：[1]中国医科大学附属盛京医院第一胸外科,沈阳110004 [2]中国医科大学附属盛京医院第一肿瘤内科,沈阳110004

出　　处：《中国胸心血管外科临床杂志》2018年第7期572-576,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的分析食管癌术后并发心房颤动(房颤)相关的危险因素,为防治食管癌术后房颤提供依据。方法回顾性分析2014年1月至2016年8月在中国医科大学附属盛京医院胸外科同一治疗组行胸腹腔镜联合和开放食管癌手术的335例患者的临床资料。其中男262例、女73例,年龄65.1(43~78)岁。结果 335例患者中有48例在术后1周内发生房颤。单因素分析发现年龄、性别、外周血管病史、心脏支架或心绞痛史、术前脑钠肽(brain natriuretic peptide,BNP)、术前左室舒张功能不全、手术方式、术中输血、淋巴结与心包粘连为可疑危险因素。多因素分析显示年龄、性别、心脏支架或心绞痛史、术前BNP、手术方式、术中输血、淋巴结与心包粘连为危险因素。结论高龄、男性、心脏支架或心绞痛病史、术前BNP≥100 ng/ml、开放手术、术中输血、淋巴结与心包粘连是本研究得出的导致食管癌术后房颤增加的危险因素。围术期对以上因素进行积极干预可能会降低术后房颤的发生率。Objective To analyze the risk factors of atrial fibrillation （AF） after radical esophagectomy, providing the basis for prevention and treatment of AF after radical esophagectomy. Methods We conducted a retrospective analysis of 335 patients＇ clinical data, who accepted laparoscopic combined thoracic or open radical esophagectomy in the same treatment group at Department of Thoracic Surgery of Shengjing Hospital of China Medical University between January 2014 and August 2016. There were 262 males and 73 females at age of 65.1 （43-78） years. Results There were 48 of 335 patients with AF within 1 week after surgery. By univariate analysis： age, gender, history of peripheral vascular disease and cardiac stents or angina pectoris, preoperative brain natriuretic peptide （BNP）, preoperative left ventricular diastolic dysfunction, operation pattern, intraoperative blood transfusion and lymph nodes and pericardial adhesion were possible risk factors. By multivariate analysis： age, gender, history of cardiac stents or angina pectoris, preoperative BNP, operation pattern, intraoperative blood transfusion and lymph nodes and pericardial adhesion were risk factors. Conclusion The risk factors of AF after radical esophagectomy are age, gender, history of cardiac stents or angina pectoris, preoperative BNP, operation pattern, intraoperative blood transfusion and lymph nodes and pericardial adhesion. Perioperative positive intervention to above factors may reduce the incidence of postoperative AF.

关 键 词：食管癌手术 心房颤动 危险因素 

分 类 号：R541.75[医药卫生—心血管疾病] R735.1[医药卫生—内科学]