肺癌术后心律失常的相关危险因素分析

Analysis of Risk Factors for Arrhythmias in Lung Cancer Patients

目的探讨肺癌术后发生心律失常的危险因素,为肺癌术后心律失常的防治提供科学依据。方法回顾分析459例肺癌手术患者的临床资料,其中肺叶楔形切除术14例,肺叶切除术387例,全肺切除术30例,探查术28例。术后发生心律失常143例。应用Logistic回归分析影响术后发生心律失常可能的危险因素。结果心律失常总发生率为31.2%。单因素分析显示,心律失常的发生与术前心电图情况、术中心包有损伤、术中出血量、FEV1/FVC、术后发生电解质紊乱相关(P<0.05)。多因素Logistic回归分析显示,术前心电图异常、术中心包有损伤、FEV1/FVC、术后发生电解质紊乱是术后心律失常的主要危险因素(P<0.05)。结论术中减少对心包和肺组织的损伤,术前采取一些预防措施,术后纠正电解质紊乱,可以减少术后心律失常的发生率。

Objective To investigate the risk factors for cardiac arrhythmia after operation of lung cancer and search for the prophylaxis of postoperative cardiac arrhythmia.Methods A retrospective analysis of 459 patients after lung cancer surgery was performed.In these patients,14 had pulmonary wedge resection,387 had lobectomy,30 had whole lung resection,28 had thoracotomy surgery,and 24 had cardiac arrhythmia after cancer operation.Univariate analysis and multivariate logistic regression were performed between arrhythmia group and non-arrhythmia group.Results Among 459 lung cancer cases,31.2% patients had postoperative cardiac arrhythmia.Univariate analysis showed that electrocardiogram abnormalities before operation,hypotension in operation,bleeding in operation,operation methods and FEV1/FVC were correlated with postoperative arrhythmia（P 0.05）.Multivariate logistic regression showed that electrocardiogram abnormalities before operation,hypotension in operation,operation methods and FEV1/FVC were the main risk factors for postoperative arrhythmia.Conclusion In order to prevent the occurrence of postoperative arrhythmia,we should choose suitable method of operation,minimal the injury of pulmonary tissue and carry out preventive methods before the operation.