微创McKeown食管癌根治术后疲劳综合征的相关危险因素分析  

Analysis of risk factors related to postoperative fatigue syndrome after radical resection of minimally invasive McKeown esophageal cancer

作　　者：王鸿伟 胡敏[1] 刘雷[1] Wang Hongwei;Hu Min;Liu Lei(Department of Surgery,Nantong Tumor Hospital,Nantong 226000,Jiangsu,China)

机构地区：[1]南通市肿瘤医院外科,江苏南通226000

出　　处：《肿瘤综合治疗电子杂志》2024年第2期140-145,共6页Journal of Multidisciplinary Cancer Management(Electronic Version)

基　　金：江苏省科技项目(BK20160132)。

摘　　要：目的 探讨微创McKeown食管癌根治术后疲劳综合征(postoperative fatigue syndrome,POFS)的相关危险因素。方法 前瞻性收集2022年1月至2023年6月于南通市肿瘤医院行微创McKeown手术的80例食管癌患者的临床资料,依据围手术期疲劳评测量表(identity-consequence fatigue scale,ICFS)对纳入的患者实施术后疲劳状况的评估,然后将患者分为POFS组(n=34)和非POFS组(n=46)。通过电子病历收集两组患者的围手术期临床资料并进行单因素分析,最后采用多因素Logistic回归分析POFS的相关因素。结果 80例患者术后的ICFS总分为(82.21±6.64)分,显著高于术前的(57.34±4.11)分(P<0.05),且日常活动、精力、活力、注意力和疲劳维度5个维度评分也均显著高于术前(均P<0.05)。80例患者术后发生POFS为34例,发生率为42.50%。单因素分析显示,POFS组年龄显著大于非POFS组(P<0.05),POFS组术前合并焦虑或抑郁、睡眠障碍、低蛋白血症比例均显著高于非POFS组(均P<0.05),POFS组术前六分钟步行试验(6-minute walking test,6MWT)距离<350 m比例显著高于非POFS组(P<0.05),POFS组麻醉时间显著短于非POFS组(P<0.05),POFS组术后视觉模拟量评分法(visual analogue scale,VAS)评分、术后血清C反应蛋白(C-reactive protein,CRP)水平、术后乳酸水平均显著高于非POFS组(均P<0.05),POFS组术后血红蛋白(hemoglobin,Hb)水平显著低于非POFS组(P<0.05)。多因素Logistic回归分析显示,术前合并焦虑或抑郁、低蛋白血症、术前6MWT距离<350 m、麻醉时间短、术后血清CRP水平高均是微创McKeown食管癌根治术POFS发生的独立危险因素(均P<0.05)。结论 微创McKeown食管癌根治术后POFS发生率较高,且与术前焦虑抑郁情绪、低蛋白血症、6MWT距离过短、麻醉时间偏短和CRP水平偏高等因素密切相关,临床应重视此类危险因素并制订针对性的措施对其进行干预,以降低POFS发生率。Objective To investigate the risk factors associated with postoperative fatigue syndrome(POFS)after radical resection of minimally invasive McKeown esophageal cancer.Method The clinical data of 80 patients with esophageal cancer who underwent minimally invasive McKeown surgery in Nantong Tumor Hospital from January 2022 to June 2023 were retrospectively collected,and the postoperative fatigue status of the included patients was evaluated according to the identityconsequence fatigue scale(ICFS),and the patients were divided into POFS group(n=34)and non-POFS group(n=46).The perioperative clinical data of the two groups were collected through electronic medical records and univariate analysis was performed,andfinally multivariate Logistic regression was used to analyze the related factors of POFS.Result The total score of postoperative ICFS in 80 patients was(82.21±6.64)scores,which was significant higher than the preoperative score of(57.34±4.11)scores(P<0.05),and theirfive dimensional scores(daily activity,energy,vitality,attention,and fatigue)were also significant higher than preoperative scores(all P<0.05).The results of univariate analysis showed that 34 out of 80 patients experienced postoperative POFS,with an incidence rate of 42.50%.Univariate analysis showed that the age of POFS group was significantly older than that of nonPOFS group(P<0.05).The proportions of preoperative anxiety or depression,sleep disorders and hypoproteinemia in POFS group were significantly higher than those in non-POFS group(all P<0.05),the proportion of preoperative 6minute walking test(6MWT)distance<350 m than group was significantly higher than that in nonPOFS group(P<0.05).The anesthesia time in POFS group was significantly shorter than that in non-POFS group(P<0.05),the postoperative pain visual analogue scale(VAS)score,postoperative serum C-reactive protein(CRP)level and postoperative lactic acid level were significantly higher than those in nonPOFS group(all P<0.05),the postoperative hemoglobin(Hb)level was signific

关 键 词：食管癌 微创手术 McKeown食管癌根治术 术后疲劳综合征 危险因素 

分 类 号：R735.1[医药卫生—肿瘤]