老年结直肠癌患者术后肺部并发症发生的影响因素  

Factors influencing the occurrence of postoperative pulmonary complications in elderly patients with colorectal cancer

作　　者：徐向杨[1] 梅菊香[1] 张莉 刘金龙 尹永胜[1] XU Xiang-yang;MEI Ju-xiang;ZHANG Li;LIU Jin-long;YIN Yong-sheng(Department of Anesthesiology,Qidong People's Hospital/Qidong Liver Cancer Institute/the Affiliated Qidong Hospital of Nantong University,Qidong 226200,Jiangsu,CHINA;Department of General Surgery,Qidong People's Hospital/Qidong Liver Cancer Institute/the Affiliated Qidong Hospital of Nantong University,Qidong 226200,Jiangsu,CHINA)

机构地区：[1]启东市人民医院、启东肝癌防治研究所、南通大学附属启东医院麻醉科,江苏启东226200 [2]启东市人民医院、启东肝癌防治研究所、南通大学附属启东医院普外科,江苏启东226200

出　　处：《海南医学》2025年第3期417-420,共4页Hainan Medical Journal

摘　　要：目的探讨老年结直肠癌患者术后肺部并发症发生的影响因素。方法回顾性分析2022年8月至2024年1月启东市人民医院收治的119例结直肠癌手术患者的临床资料。统计术后30 d内患者肺部并发症的发生情况,并根据术后是否发生肺部并发症分为术后合并肺部并发症组(并发症组,n=28)和术后未合并肺部并发症组(无并发症组,n=91)。比较两组患者的临床资料,采用多因素Logistic回归模型分析老年结直肠癌患者术后并发肺部并发症的影响因素。结果119例老年CRC手术患者术后发生肺部并发症28例(23.53%)。并发症组患者的年龄大于无并发症组,吸烟史、肺部疾病史、术前衰弱、ASA分级中Ⅲ(Ⅳ)级及开腹手术的患者占比均明显高于无并发症组,复苏时间明显长于无并发症组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,吸烟史(OR=5.387,95%CI:1.672~17.354)、复苏时间(OR=1.054,95%CI:1.007~1.104)、术前衰弱(OR=7.277,95%CI:1.290~41.054)、手术方式(OR=0.136,95%CI:0.020~0.924)均是影响术后患者发生肺部并发症的危险因素。结论吸烟史、复苏时间、术前衰弱、手术方式均是老年结直肠癌患者术后肺部并发症发生的独立危险因素。Objective To investigate the influencing factors of postoperative pulmonary complications in elderly patients with colorectal cancer.Methods A total of 119 patients with colorectal cancer treated in Qidong People's Hospital from August 2022 to January 2024 were retrospectively analyzed.The occurrence of pulmonary complications in patients within 30 days after surgery was counted,and according to whether pulmonary complications occurred after surgery,the patients were divided into a group with postoperative pulmonary complications(n=28)and a group without postoperative pulmonary complications(n=91).The medical records were compared between the two groups.Then the influencing factors of postoperative pulmonary complications in elderly patients with colorectal cancer were analyzed by multivariate logistic regression model.Results Among the 119 elderly patients undergoing surgery for colorectal cancer,28(23.53%)developed postoperative pulmonary complications.Age,the proportions of patients with smoking history,lung disease history,preoperative frailty,ASA grade ofⅢ(Ⅳ),and laparotomy,and the duration of resuscitation of patients in group with postoperative pulmonary complications were significantly higher/longer than those in group without postoperative pulmonary complications(P<0.05).Multivariate logistic regression analysis showed that smoking history(OR=5.387,95%CI:1.672-17.354),duration of resuscitation(OR=1.054,95%CI:1.007-1.104),preoperative frailty(OR=7.277,95%CI:1.290-41.054),and operation mode(OR=0.136,95%CI:0.020-0.924)were independent risk factors for postoperative pulmonary complications.Conclusion Smoking history,duration of resuscitation,preoperative frailty,and operation mode were independent risk factors for postoperative pulmonary complications in elderly patients with colorectal cancer.

关 键 词：老年 结直肠癌 肺部并发症 术前衰弱 术前评估 影响因素 

分 类 号：R735[医药卫生—肿瘤]