肺癌患者术后住院时间延长(>7天)的影响因素分析  

Influencing Factors of Prolonged Postoperative Length of Stay(>7 days)in Patients Undergoing Lung Cancer Surgery

作　　者：冯文红 廖小清[2] 张远强[3] 牟云飞[4] 张瑞[5] 戴维 李强 Feng Wenhong;Liao Xiaoqing;Zhang Yuanqiang;Mu Yunfei;Zhang Rui;Dai Wei;Li Qiang(Department of Thoracic and Cardiovascular Surgery,Jiangyou People's Hospital,Mianyang 621700,Sichuan,China;Department of Cardiothoracic Surgery,People’s Hospital of Dazhu County,Dazhou 635100,Sichuan,China;Department of Cardiothoracic Surgery,Zigong First People's Hospital,Zigong 643000,Sichuan,China;Department of Thoracic Surgery,the Third People's Hospital of Chengdu,Chengdu 610031,Sichuan,China;Department of Thoracic Surgery,Chengdu Seventh People's Hospital,Chengdu 610041,Sichuan,China;Department of Thoracic Surgury,Sichuan Cancer Hospital&Institue,Sichuan Cancer Center,School of Medicine,University of Electronic Science and Technology of China,Chengdu 610041,Sichuan,China)

机构地区：[1]江油市人民医院胸心血管外科,四川绵阳621700 [2]大竹县人民医院心胸肿瘤外科,四川达州635100 [3]自贡市第一人民医院胸心外科,四川自贡643000 [4]成都市第三人民医院胸外科,成都610031 [5]成都市第七人民医院胸外科,成都610041 [6]四川省肿瘤医院·研究所,四川省癌症防治中心,电子科技大学医学院胸外科,成都610041

出　　处：《肿瘤预防与治疗》2021年第11期1019-1025,共7页Journal of Cancer Control And Treatment

基　　金：四川省科技厅项目(编号:2019YFH0070)。

摘　　要：目的:调查肺癌患者术后住院时间延长(>7天)的影响因素。方法:分析2017年11月至2020年1月多中心前瞻性队列研究数据库(CN-PRO-Lung1)中421例肺癌手术患者的临床资料。根据术后住院时间将患者分为正常组(≤7天)和延长组(>7天),采用二元Logistic回归确定独立影响因素。结果:男222例,女199例,平均年龄为(55.70±10.38)岁,中位术后住院时间为7天,其中139例(33.0%)患者术后住院时间延长。单因素分析结果显示,性别、年龄、吸烟史、饮酒史、合并症、手术入路、手术方式、淋巴结清扫、术后并发症级别、病理类型、病理分期和医院类型与肺癌患者术后住院时间延长显著相关(均P<0.05)。多因素分析结果显示,肺叶切除、扩大切除、术后并发症≥Ⅰ级和市县级三级医院是肺癌患者术后住院时间延长的独立危险因素(均P<0.001)。结论:肺癌患者术后住院时间延长较常见,其中肺叶切除、扩大切除、术后发生≥Ⅰ级并发症和在市县级三级医院接受治疗的患者更容易发生术后住院时间延长(>7天)。Objective:To investigate the influencing factors of prolonged postoperative length of stay(PPLS)(>7 days)in patients undergoing lung cancer surgery.Methods:Clinical data of 421 patients undergoing lung cancer surgery in a multicenter prospective cohort study database(CN-PRO-Lung 1)from November 2017 to January 2020 were analyzed.The patients were assigned to the normal group(≤7 days)and the prolonged group(>7 days)according to PPLS.Binary logistic regression was used to identify the independent influencing factors.Results:There were 222 males and 199 females,with an average age of(55.70±10.38)years.The median postoperative length of stay was 7 days and 139(33.0%)patients had PPLS.Univariate analysis showed that gender,age,smoking history,drinking history,comorbidity,surgical approach,surgical type,lymph node dissection,postoperative complication grade,pathological type,pathological stage and hospital type were significantly correlated to PPLS(all P<0.05).Multivariate analysis showed that lobectomy,extended resection,postoperative complication grade≥I and municipal/county tertiary hospital were independent risk factors of PPIS in patients undergoing lung cancer surgery(all P<0.001).Conclusion:PPLS remains common in patients undergoing lung cancer surgery.Among them,patients with lobectomy,extended resection,postoperative complication grade≥I,and those hospitalized in municipal or county tertiary hospitals are more likely to have a PPLS(>7 days).

关 键 词：肺癌 手术 术后住院时间延长 影响因素 

分 类 号：R730.7[医药卫生—肿瘤] R734.2[医药卫生—临床医学]