老年胃癌患者术后肺部并发症的相关危险因素分析

Analysis of risk factors for postoperative pulmonary complications of elderly patients with gastric cancer

目的探讨老年胃癌患者术后肺部并发症(PPCs)的相关危险因素,为PPCs的个体化预防提供科学依据。方法回顾性分析2008年10月至2013年12月263例65岁以上胃癌患者PPCs发生情况,采用logistic多元回归方法分析老年胃癌患者PPCs的相关危险因素。结果 263例老年胃癌患者中出现PPCs 69例,发病率为26.24%(69/263)。Logistic回归分析显示,吸烟史、体质量指数(BMI)≥24 kg·m^(-2)、糖尿病、低蛋白血症、实测最大通气量/理论最大通气量<60%、第1秒用力呼气量/用力肺活量<50%、术中出血量≥500 m L、手术时间≥4 h均是老年胃癌患者PPCs的独立危险因素(P<0.05)。结论吸烟史、BMI≥24 kg·m^(-2)、糖尿病、低蛋白血症、术前肺功能差、术中出血量多及手术时间长是老年胃癌患者PPCs的危险因素。

Objective To investigate the risk factors for postoperative pulmonary complications（ PPCs） of elderly patients with gastric cancer. Methods The PPCs of 263 patients（ 65 years） with gastric cancer from October 2008 to December 2013 were retrospectivly analyzed,and the risk factors for PPCs of elderly patients with gastric cancer were analyzed by multi-variable logistic regression analysis. Results Among the 263 elderly patients,69 cases suffered from PPCs,the incidence rate of PPCs was 26. 24%（ 69 /263）. Logistic regression analysis showed that smoking history,body mass index ≥24 kg·m^-2,diabetes history,hypoproteinemia,the ratio of the observed maximal voluntary ventilarion（ MVV） to theoretical MVV 60%,the ratio of the forced expiratory volume in 1 second to forced vital capacity〈50%,intraoperative blood loss 〉500 m L and the operation time 〉4 h were the independent risk factors for PPCs of elderly patients with gastric cancer（ P〈0. 05）. Conclusion Smoking history,BMI≥24 kg·m^-2,diabetes history,hypoproteinemia,preoperative pulmonary function disturbance,more volume of intraoperative blood loss and long operation time were the independent risk factors for PPCs of elderly patients with gastric cancer.