食管癌术后肺部并发症的危险因素分析

Analysis of risk factors of postoperative pulmonary complications of esophageal carcinoma

目的探讨食管癌术后肺部并发症(postoperative pulmonary complications,PPC)的特点及影响其发生的危险因素。方法对2014年3月—2015年5月295例行食管癌手术患者进行回顾性分析,根据围手术期有无肺并发症发生分为PPC组和正常组,对患者的临床资料先进行单因素分析筛选,将有意义的变量再进行多因素回归分析。结果 1两组患者术后患者住院期间肺部并发症发生率为12.9%;2单因素分析显示:PPC组与正常组在年龄、体重、吸烟、肺功能(FEV1)、术中液体入量正平衡比较差异有统计学意义(P均<0.05);3对上述五项指标行logistic多因素回归分析显示:年龄>70岁(OR=14.43,P<0.05)、吸烟指数>400(OR=12.21,P<0.01)、体质指数<18 kg/m2(OR=15.74,P<0.01)与肺部并发症发生明显相关。结论肺部并发症是食管癌术后最常见的并发症,年龄>70岁、吸烟、低体重是围手术期肺部并发症发生的危险因素。

Objective To explore the features and risk factors of postoperative pulmonary complications （PPC） of esophageal carcinoma. Methods The clinical data of 295 patients undergoing esophagectomy between March 2014 and May 2015 were retrospectively analyzed. The patients were assigned to PPC group and normal group. The clinical data were screened by univariate analysis, then the identified factors were subject to multivariate regression analysis. Results ①The overall incidence of PPC of two groups was 12.9%.②Univariate analysis revealed that there were significant differences in age, body weight, smoking, preoperative pulmonary function （FEV1） and volume overload between two groups （P〈0.05 for all）. ③Multivariate regression analysis indicated that age〉70 years （OR=14.43, P〈0.05）, smoking index〉400 （OR=12.21, P〈0.01） and body weight〈18 kg/m^2 （OR=15.74, P〈0.01） were significantly related to PPC. Conclusion PPC is commonly occurred after esophagectomy for esophageal carcinoma, and age〉70 years, smoking and low body weight are risk factors of PPC.