431例老年食管癌患者术后肺部并发症情况及危险因素分析

Postoperative pulmonary complications and risk factors analysis of 431 cases of elderly patients with esophageal cancer

目的分析老年食管癌患者术后肺部并发症的发生情况,并对其危险因素进行探讨。方法回顾2005年1月—2014年12月间收治的431例老年食管癌患者资料,对其术后肺部并发症情况进行分析。依据是否发生肺部并发症将患者分为观察组(有并发症)和对照组(无并发症)。用单因素和Logistic分析对患者术后发生肺部并发症的危险因素进行分析。结果 431例患者中,124例患者出现了肺部并发症(28.8%),其中肺炎(10.4%)、呼吸衰竭(5.8%)、急性呼吸窘迫综合征(4.9%)的发生率最高。单因素结果显示:年龄、过量吸烟、肺结核病史、糖尿病史、肺功能低、手术时间、术中出血量、术后其他并发症是食管癌患者术后发生肺部并发症的单因素危险因素。Logistic的因素分析结果显示:年龄、过量吸烟、肺结核病史、糖尿病史、肺功能低、手术时间、术中出血量、术后其他并发症是食管癌患者术后发生肺部并发症的独立危险因素。结论老年食管癌患者术后易发生肺部并发症,年龄、过量吸烟、肺结核病史、糖尿病、肺功能低、手术时间、术中出血量、术后其他并发症是食管癌患者术后发生肺部并发症的危险因素。

Objective To analyze postoperative pulmonary complications of dderly patients with esophageal cancer, and investigate the risk factors. Methods Four hundred and thirty-one cases of elderly patients with esophageal cancer in our group from January 2005 to December 2014 were retrospectively analyzed, and the postoperative pulmonary complications were analyzed. The patients were divided into observation group（ with complications） and control group（ without complica- tions） according to with or without pulmonary complications. The risk factors of postoperative pulmonary complications were analyzed by univariate and Logistic regression analysis. Results In all 431 cases of patients, 124 patients appeared pulmonary complications （28.8 % ）, including highest incidence of pneumonia （ 10.4% ）, respiratory failure （ 5.8% ）, a- cute respiratory distress syndrome（4.9% ）. Univariate results showed that the age, excessive smoking, pulmonary tubercu- losis history, diabetes history, low lung function, operation time, blood loss, and other postoperative complications were the univariate risk factor of postoperative pulmonary complications of patients with esophageal cancer. Logistic regression anal- ysis showed that age, excessive smoking, pulmonary tuberculosis history, diabetes history, low lung function, operation time, blood loss, and other postoperative complications were independent risk factors of postoperative pulmonary complica- tions of patients with esophageal cancer. Conclusion Elderly patients with esophageal cancer easily appear pulmonary complications after surgery. The age, excessive smoking, pulmonary tuberculosis history, diabetes history, low lung func- tion, operation time, blood loss, and other postoperative complications were independent risk factors of postoperative pulmonary complications of patients with esophageal cancer.