影响食管癌胸腔镜食管切除术后肺部并发症的因素  

Factors influencing pulmonary complications after thoracoscopic esophagectomy for esophageal cancer

作　　者：仲飞燕 周晶晶 陈海生 仲扬荣 ZHONG Feiyan;ZHOU Jingjing;CHEN Haisheng;ZHONG Yangrong(Department of Thoracic Surgery,Haian People s Hospital,Nantong 226600,China)

机构地区：[1]海安市人民医院胸外科,江苏南通226600

出　　处：《临床肿瘤学杂志》2024年第6期581-585,共5页Chinese Clinical Oncology

摘　　要：目的探讨食管癌胸腔镜食管切除术后肺部并发症(PPC)的危险因素。方法回顾性收集2019年1月至2022年6月期间接受胸腔镜食管切除术的181例食管癌患者的临床病历资料。记录患者术后PPC发生情况。采用多因素Logistic回归模型分析影响PPC发生的因素,并构建列线图。结果术后46例患者发生PCC。PPC与年龄、ASA分级、吸烟史、COPD和术后谵妄均有关(P<0.05);与其他临床病理参数无关(P>0.05)。多因素Logistic回归分析结果显示年龄>60岁、ASA分级Ⅲ/Ⅳ级、COPD和术后谵妄是PPC发生风险的独立危险因素(P<0.05)。构建列线图预测模型显示C指数为0.67(95%CI:0.62~0.72)。结论术前COPD和术后谵妄是食管癌患者胸腔镜食管切除术PPC风险的独立危险因素,建议采取预防措施以降低食管癌患者食管切除术PPC的发生率。Objective To investigate the risk factors of pulmonary complications(PPC)after thoracoscopic esophagectomy for esophageal cancer.Methods Clinical data of 181 patients with esophageal cancer who underwent thoracoscopic esophagectomy from January 2019 to June 2022 were retrospectively collected.The occurrence of postoperative PPC was recorded.Multivariate Logistic regression model was used to analyze the factors affecting the occurrence of PPC,and a nomogram was constructed.Results PCC occurred in 46 patients after operation.PPC was associated with age,ASA grading,smoking history,COPD and postoperative delirium(P<0.05).There was no correlation with other clinicopathological parameters(P>0.05).Multivariate Logistic regression analysis showed that age>60 years old,ASA gradeⅢ/Ⅳ,COPD and postoperative delirium were independent risk factors for PPC(P<0.05).The constructed nomogram prediction model showed that the C index was 0.67(95%CI:0.62-0.72).Conclusion Preoperative COPD and postoperative delirium are independent risk factors for PPC in patients with esophageal cancer undergoing thoracoscopic esophagectomy.It is recommended to take preventive measures to reduce the incidence of PPC in patients with esophageal cancer undergoing esophagectomy.

关 键 词：食管癌 胸腔镜食管切除术 术后肺部并发症 危险因素 

分 类 号：R735.1[医药卫生—肿瘤]