高龄肺癌患者袖状与全肺切除术后早期并发症分析

Analysis of early postoperative complications in elder patients with lung cancer undergoing sleeve resection or pneumonectomy

目的比较接受支气管袖状切除与全肺切除的高龄肺癌患者术后并发症的发生情况,并对相关危险因素进行分析。方法收集78例70岁以上肺癌患者的临床资料,其中接受支气管袖状切除手术55例(袖状切除组),接受全肺切除手术23例(全肺切除组),比较两组患者的术前资料、术中情况及术后并发症的发生情况,分析与并发症发生相关的危险因素。结果两组患者术后心律失常的发生率比较差异无统计学意义(P>0.05);袖状切除组患者术后气管镜吸痰次数显著多于全肺切除组(P<0.05)。统计学分析结果显示:术后呼吸道和心律失常并发症的发生与术式的选择无明显相关性(P>0.05),而术前肺功能指标一秒用力呼气量(FEV1)是高龄肺癌患者术后发生心律失常的独立危险因素(P=0.015)。结论对于高龄肺癌患者,支气管袖状切除与全肺切除两种术式对术后并发症的发生无明显影响;支气管袖状切除术术后更需重视气道管理;术前肺功能差是患者术后发生心律失常的危险因素。

Objective To investigate the prevalences of postoperative complications in elder patients with lung caner undergoing sleeve resection or pneumonectomy,and explore the related risk factors. Methods The clinical data of 78 patients with lung cancer aged more than 70 years were collected.Among the 78 patients,55 underwent sleeve resection of bronchus(sleeve resection group) and 23 received pneumonectomy(pneumonectomy group).The preoperative data,perioperative conditions and prevalences of postoperative complications were compared between groups,and the risk factors related to complications were analysed. Results There was no significant difference in prevalence of postoperative arrhythmia between groups(P>0.05).The frequency of aspiration of sputum with bronchoscopy in sleeve resection group was significantly higher than that in pneumonectomy group(P<0.05).Statistical analysis revealed that the occurrences of postoperative respiratory tract complication and postoperative arrhythmia were not significantly related to the surgical procedures(P>0.05),while preoperative lung function of forced expiratory volume in one second(FEV1) was independent risk factor for postoperative arrhythmia in elder patients with lung cancer(P=0.015). Conclusion Sleeve resection of bronchus and pneumonectomy do not have significant effect on postoperative complications in elder patients with lung cancer.More attention should be paid to postoperative airway management for patients undergoing sleeve resection of bronchus,and poor lung function is risk factor for postoperative arrhythmia.