肺癌患者胸腔镜术后心肺并发症的影响因素分析  

Influencing factors of cardiopulmonary complications in patients with lung cancer after thoracoscopic surgery and nursing intervention

作　　者：白娟 白娜娜 刘易莎 山卉[2] BAI Juan;BAI Na-na;LIU Yi-sha;SHAN Hui(Xi 'an Central Hospital,Chest and Thoracic Surgery,Xi' an 710003,Shaanxi;Xi'an Central Hospital,Xi'an 710003,Shaanxi,CHINA)

机构地区：[1]西安市中心医院心胸外科,陕西西安710003 [2]西安市中心医院骨科,陕西西安710003

出　　处：《海南医学》2019年第20期2668-2670,共3页Hainan Medical Journal

摘　　要：目的分析肺癌患者胸腔镜术后心肺并发症的相关危险因素。方法回顾性分析2014年1月至2018年12月于西安市中心医院心胸外科行胸腔镜手术治疗的321例肺癌患者的临床资料,根据术后是否发生心肺并发症将患者分为并发症组50例和无并发症组271例,收集患者的基线资料和实验室、手术指标等,分析影响肺癌患者胸腔镜术后心肺并发症的危险因素。结果单因素分析结果显示,肺癌患者胸腔镜术后心肺并发症与年龄、目前吸烟、合并基础疾病、FEV1%、WBC、手术时间、术中出血量、术后住院时间均有关(P<0.05),与性别、病理类型、TNM分期、病变部位和手术方式无关(P>0.05);多因素分析结果显示,年龄≥65岁(OR=2.815,P<0.05)、目前吸烟(OR=10.496,P=0.000)、手术时间>3h(OR=7.668,P<0.05)、FEV1%<60.00%(OR=2.617,P<0.05)、合并基础疾病(OR=2.787,P<0.05)是影响肺癌患者胸腔镜术后心肺并发症的危险因素。结论年龄≥65岁、目前吸烟、手术时间>3h、FEV1%<60.00%、合并基础疾病是影响肺癌患者胸腔镜术后心肺并发症的危险因素。Objective To analyze the risk factors of cardiopulmonary complications after thoracoscopic lung cancer surgery, and to explore the effect of nursing intervention on preventing cardiopulmonary complications. Methods The clinical data of 321 patients with lung cancer who underwent thoracoscopic surgery in cardiothoracic surgery of Xi'an Central Hospital from January 2014 to December 2018 were retrospectively analyzed. According to the occurrence of cardiopulmonary complications, the patients were divided into complications group (50 cases) and non-complications group (271 cases). The baseline data and laboratory data were collected. The risk factors of cardiopulmonary complications in lung cancer patients after thoracoscopic surgery were analyzed. Results Univariate analysis showed that the complications of lung cancer patients after thoracoscopic surgery were related to age, current smoking, complication with underlying diseases, the percentage of forced expiratory volume in one second to predicted value (FEV1%), white blood cell (WBC), operation time, intraoperative bleeding volume, and hospitalization time (P<0.05), but not to sex, pathological type, TNM stage, lesion location, and operation method (P>0.05). Multivariate analysis showed that age (>65 years old)(OR=2.815, P<0.05), current smoking (OR=10.496, P<0.05), operation time>3 hours (OR=7.668, P<0.05), FEV1%< 60.00%(OR=2.617, P<0.05), complication with underlying diseases (OR=2.787, P<0.05) were risk factors for cardiopulmonary complications after thoracoscopic surgery in lung cancer patients. Conclusion Age>65 years old, current smoking, operation time>3 h, FEV1%<60.00%, and complication with underlying diseases are risk factors for cardiopulmonary complications in patients with lung cancer after thoracoscopic surgery.

关 键 词：肺癌 胸腔镜 心肺并发症 因素 肺肿瘤 

分 类 号：R734.2[医药卫生—肿瘤]