术前低白蛋白血症与肺切除术后肺部并发症的关系  

Relationship between preoperative hypoalbuminemia and pulmonary complications after pneumonectomy

作　　者：孙梦寒 茆梦 孙杰[1] Sun Menghan;Mao Meng;Sun Jie(Department of Anesthesiology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院麻醉科,210029

出　　处：《中华麻醉学杂志》2020年第7期795-799,共5页Chinese Journal of Anesthesiology

摘　　要：目的回顾性分析本院2018年1月至2018年12月首次行择期胸腔镜肺切除术且肺功能正常的患者临床资料。按术前48 h内最低血清白蛋白水平分为低白蛋白血症组(<35 g/L)及正常白蛋白水平组(≥35 g/L),通过倾向性评分匹配2组患者基线信息和术中及术后情况。根据是否发生术后肺部并发症(PPCs),分为并发症组和无并发症组。采用logistic回归分析筛选PPCs的危险因素。纳入1127例患者,并发症组306例,无并发症组821例,logistic回归分析显示:低白蛋白血症是肺切除术患者PPCs的独立危险因素(OR值=1.643,95%可信区间1.201~2.249,P<0.05)。倾向性评分匹配后,正常白蛋白水平组498例,低白蛋白血症组178例。与正常白蛋白水平组比较,低白蛋白血症组PPCs总发生率和肺炎发生率升高(P<0.05)。综上所述,术前低白蛋白血症是肺切除术后患者PPCs发生的危险因素。A retrospective analysis was performed on the clinical data of patients with normal lung function who underwent elective thoracoscopic lung resection for the first time in our hospital from January 2018 to December 2018.According to the minimum serum albumin level obtained within 48 h before operation,the patients were divided into hypoalbuminemia group(<35 g/L)and normal albumin level group(≥35 g/L).The perioperative baseline data and intraoperative and postoperative conditions were compared between the two groups after propensity score matching.The risk factors for postoperative pulmonary complications(PPCs)in the perioperative period were analyzed by logistic regression analysis,and the patients were divided into complication group and non-complication group according to whether PPCs occurred.Among the 1127 patients enrolled in the study,there were 306 cases in complication group,and 821 cases in non-complication group.Logistic regression analysis showed that hypoalbuminemia was an independent risk factor for PPCs in the patients undergoing thoracoscopic lung resection(OR=1.643,95%confidence interval 1.201-2.249,P<0.05).After matching the propensity score,there were 498 cases in normal albumin group and 178 cases in hypoalbuminemia group.The total incidence of PPCs and incidence of pneumonia were significantly higher in hypoalbuminemia group than in normal albumin level group(P<0.05).In summary,preoperative hypoalbuminemia is a risk factor for pulmonary complications after pneumonectomy.

关 键 词：低白蛋白血症 手术后并发症 肺切除术 

分 类 号：R655.3[医药卫生—外科学]