术前肺功能指标与食管癌微创术后肺部感染的关系  

Correlation between Preoperative Pulmonary Function Indicators and Postoperative Pulmonary Infections of Esophageal Cancer Treated with Minimally Invasive Surgery

作　　者：肖丽霞 齐丽雯 XIAO Lixia;QI Liwen(Department of Thoracic Surgery,Feicheng People's Hospital of Shandong Province,Feicheng 271600,China;Department of Gastroenterology,Feicheng People's Hospital of Shandong Province,Feicheng 271600,China)

机构地区：[1]山东省肥城市人民医院胸外科,山东肥城271600 [2]山东省肥城市人民医院消化内科,山东肥城271600

出　　处：《中国医药指南》2023年第21期57-60,共4页Guide of China Medicine

摘　　要：目的分析术前肺功能指标与食管癌微创术后肺部感染的关系,为预防和控制医院感染提供研究依据。方法选取2017年10月至2019年10月的198例食管癌患者作为研究对象,患者均行胸腹腔镜食管癌根治术,根据是否发生肺部感染将患者分为感染组和未感染组,经单因素、多因素分析术后肺部感染相关因素。结果198例食管癌患者,36例患者发生肺部感染,感染率为18.18%,感染组患者的年龄、合并糖尿病患者比例、合并冠心病患者比例高于未感染组,术前1秒用力呼气容积(forced expiratory volume in one second,FEV_(1))、术前呼气峰值流量峰值(peak expiratoryflow,PEF)低于未感染组,差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示,合并糖尿病、术前FEV_(1)、术前PEF是影响胸腹腔镜食管癌根治术后肺部感染的主要因素,其中,术前FEV_(1)、术前PEF是保护性因素。结论合并糖尿病、术前FEV_(1)、术前PEF是微创食管癌根治术后感染的主要影响因素,临床医师应重视对于患者术前肺功能的评价和干预,以达到减少术后感染、确保手术效果、改善预后的目的。Objective To analyze the correlation the preoperative pulmonary function indicators and the postoperative pulmonary infections of esophageal cancer treated with minimally invasive surgery to provide research basis for the prevention and control of nosocomial infections.Methods 198 patients with esophageal cancer from October 2017 to October 2019 were selected as the research subjects.All patients were treated with thoracoscopic esophagectomy.The patients were divided into infection group and non-infection group according to whether there was pulmonary infection.The related factors of postoperative pulmonary infection were analyzed by univariate and multivariate analysis.Results Among 198 patients with esophageal cancer,36 patients had pulmonary infections,the infection rate was 18.18%.The age,the proportion of diabetes mellitus and the proportion of coronary heart disease of the patients in the infected group were higher than those in the non-infection group.Forced expiratory volume in one second(FEV_(1))and peak expiratory flow(PEF)in the infected group were lower than those in the non-infection group,the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that diabetes mellitus,preoperative FEV_(1) and preoperative PEF were the main factors affecting pulmonary infection after thoracoscopic and laparoscopic radical resection of esophageal cancer.Among them,preoperative FEV_(1) and preoperative PEF were protective factors.Conclusions Diabetes mellitus,preoperative FEV_(1) and preoperative PEF are risk factors for infection after minimally invasive radical resection of esophageal cancer.The clinicians should pay attention to the evaluation and intervention of preoperative pulmonary functions,so as to reduce postoperative infection,ensure the effects of operation and improve the prognosis.

关 键 词：食管癌 肺功能 胸腹腔镜根治术 术后肺部感染 

分 类 号：R735.1[医药卫生—肿瘤]