术前合并心律失常的非小细胞肺癌患者围术期安全性及近期预后的临床分析  

Clinical analysis of perioperative safety and short-term prognosis of non-small cell lung cancer patients with preoperative arrhythmia

作　　者：刘云飞 王小文[1] 李林峻[1,2] 张诚[1,2] 蒋迎九[1] 吴庆琛[1] LIU Yunfei;WANG Xiaowen;LI Linjun;ZHANG Cheng;JIANG Yingjiu;WU Qingchen(Department of Cardiothoracic Surgery,The First Affiliated Hospital of Chongqing Medical University,Chongqing,400016,P.R.China;Department of Cardiothoracic Surgery ICU,The First Affiliated Hospital of Chongqing Medical University,Chongqing,400016,P.R.China)

机构地区：[1]重庆医科大学附属第一医院胸心外科,重庆400016 [2]重庆医科大学附属第一医院胸心外科ICU,重庆400016

出　　处：《中国胸心血管外科临床杂志》2023年第8期1158-1163,共6页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：重庆市科学技术委员会项目(CSCT2019JCYJ-MSXMX0827)。

摘　　要：目的分析术前合并心律失常的非小细胞肺癌(non-small cell lung cancer,NSCLC)患者围术期安全性及其对近期预后的影响。方法回顾性分析2020年8月—2021年3月重庆医科大学附属第一医院胸心外科收治的NSCLC手术患者的临床资料,根据患者术前24 h动态心电图检查结果是否合并心律失常,分为心律失常组和对照组。比较两组患者术中、术后心血管相关事件发生率及近期预后情况。结果共纳入466例患者,心律失常组患者共338例,男176例、女162例,年龄68.0(63.0,72.0)岁,对照组患者共128例,男59例、女69例,年龄66.5(60.0,72.0)岁。心律失常组共26例(7.7%)患者术前安置了临时起搏器。心律失常组患者术中心血管相关事件发生率与对照组差异无统计学意义[100(29.6%)vs.28(21.9%),P=0.096];两组患者术中血流动力学指标差异也无统计学意义(P均>0.05)。心律失常组患者术后心律失常事件发生率高于对照组[112(33.1%)vs.11(8.6%),P<0.001],差异有统计学意义。心律失常组患者平均术后住ICU时间长于对照组患者[(1.1±0.7)d vs.(1.0±0.6)d,P=0.039],差异有统计学意义。结论术前合并心律失常的NSCLC患者术中发生心血管相关事件风险并未显著增加,但增加术后心律失常事件发生率及延长住ICU时间。Objective To analyze the perioperative safety and the short-term prognosis of non-small cell lung cancer(NSCLC)patients with preoperative arrhythmia.Methods The clinical data of NSCLC patients treated in the Department of Cardiothoracic Surgery,the First Affiliated Hospital of Chongqing Medical University from August 2020to March 2021 were collected and observed.The patients were divided into an arrhythmia group and a control group according to whether there was arrhythmia in the 24 h ambulatory electrocardiogram examination report before operation.The incidence of intraoperative and postoperative cardiovascular events and short-term prognosis were compared between the two groups.Results A total of 466 patients were included in this study,including 338 patients in the arrhythmia group,176 males and 162 females,with a median age of 68.0(63.0,72.0)years,and 128 patients in the control group,59 males and 69 females,with a median age of 66.5(60.0,72.0)years.A total of 26 patients(7.7%)in the arrhythmia group were placed with temporary pacemakers before operation.There was no significant difference in the incidence of cardiovascular related events between the two groups[100(29.6%)vs.28(21.9%),P=0.096].The incidence of postoperative arrhythmia events in the arrhythmia group was higher than that in the control group[112(33.1%)vs.11(8.6%),P<0.001].The average postoperative ICU stay in the arrhythmia group was longer than that in the control group(1.1±0.7 d vs.1.0±0.6 d,P=0.039).Conclusion Preoperative arrhythmia does not increase the risk of intraoperative cardiovascular events in NSCLC patients,but increases the incidence of postoperative arrhythmia events and prolongs ICU stay.

关 键 词：心律失常 肺癌 围术期 近期预后 

分 类 号：R734.2[医药卫生—肿瘤] R541.7[医药卫生—临床医学]