肺癌肺切除术后心律失常的相关因素分析

Analysis of Correlative Factors of Arrhythmia for the Patients with Lung Cancer after Operation.

目的探讨肺癌肺切除术后发生心律失常的相关因素。方法对86例肺癌肺切除术后第1日行12导联心电图检测，分析心包内肺切除和常规肺切除、术式（全肺和肺叶）、术前心电图、年龄、肺功能对心律失常的影响。结果术后发生心律失常43例（50．0％），其中窦性心动过速31例、房性早搏和交界性早搏5例、房颤7例，分别占心律失常的72．1％、11．6％、16。3％。心包内肺切除心律失常22例，占62．9％，与常规肺切除比较有统计学差异（P〈0．05）。年龄≥60岁术后心律失常21例，房颤7例，发生率分别是63．6％、21．2％，与年龄〈60岁比较有统计学差异（P〈0．05）。全肺和肺叶切除术后心律失常比较无差异（P〉0．05），术前心电图、肺功能异常术后心律失常与术前心电图、肺功能正常比较无差异（P〉0．05）。结论心包内肺切除、年龄≥60岁患者肺癌肺切除术后心律失常发生较高，60岁以上患者术后更易发生房颤。全肺切除、术前心电图和肺功能异常，术后房颤发生率较高。

Objective To explore the correlative factors of arrhythmia for the patients with lung cancer after operation. Methods To record the electrocardiogram for the 86 patients with lung cancer at the first day after operation. To analyse the factors, including the intropericardial pneumonectomy, conventional pneumonectomy, surgical opproach （pneumonectomy and lobectomy） , electrocardiogram before operation, age and lung function, which induced the arrhythmia. Results The arrhythmia occurred in 43 cases （50.0%） after operation. Among them, sinus tachycardia occurred in 31 cases, supraventricular premature occurred in 5 cases, atrial fibrillation occurred in 7 cases. The ratio among the group of arrhythmia were 72.1%, 11.6% and 16.3%. The arrhythmia occurred in 22 cases （62.9%） after intropericardial pneumonectomy. Compared with conventional pneumonectomy, there was significant difference between them （P〈0.05） . The arrhythmia and atrial fibrillation occurred in 21 cases （63.6%） and 7 cases （21.2%） who were over 60 years old separately. Compared with the patients who were less than 60 years old, there was significant difference between them （P〈0.05） .There was no significant difference for the ratio of arrhythmia between pneumonectomy and lobectomy. There was no significant difference for the ratio of arrhythmia between the patients with abnormal electrocardiogram, lung function and the patients with normal electrocardiogram , lung function. Conclusion There was a higher incidence of arrhythmia in the patients with lung cancer after intropericardial pneumonectomy, who were over 60 years old, atrial fibrillation often occurred in the patients with the age over 60 years old. The ratio of atrial fibrillation occurred after operation was high in the patients with pneumonectomy, abnormal electrocardiogram and lung function before operation.