结肠癌根治术后并发肺部感染的影响因素

Analysis of influencing factors for pulmonary infection after radical resection of colon cancer

目的探索结肠癌患者行结肠癌根治术后并发肺部感染的影响因素。方法前瞻性纳入2014年10月至2016年10月期间于大冶市人民医院行结肠癌根治术的56例患者作为研究对象,观察术后并发肺部感染情况,并收集可能影响并发肺部感染的资料。结果最终纳入53例患者的临床资料,所有患者的临床数据完整,其中13例患者术后并发肺部感染,40例患者未见明显病情加重、未并发肺部感染。logistic回归分析结果显示:结肠癌术后并发肺部感染的影响因素有1 s用力呼气量(FEV_1)/用力肺活量(FVC)值(OR=1.174,P=0.033)、手术时间(OR=1.638,P=0.012)、术后血清和肽素(COP)水平(OR=1.328,P=0.032)及术后降钙素原(PCT)水平(OR=1.465,P=0.042)。受试者工作特征曲线(ROC)结果显示:手术时间为6.207 h、术后COP水平为10.420 pmol/L及术后PCT水平为3.676 ng/m L时,具有预测结肠癌根治术后并发肺部感染的最佳评判效能。结论 FEV1/FVC值、手术时间、术后COP水平及术后PCT水平是结肠癌根治术后并发肺部感染的独立影响因素,其中手术时间为6.207 h、术后COP水平为10.420 pmol/L及术后PCT水平为3.676 ng/m L时,预测效能最佳。

Objective To explore the influencing factors for pulmonary infection after radical resection of colon cancer. Methods A cohort study included 56 patients who underwent radical resection of colon cancer in People＇s Hospital of Daye City from Oct. 2014 to Oct. 2016 were followed-up prospectively, to observe the occurrence of pulmonary infection, and collectting the related factors for pulmonary infection in addition. Results The clinical data of 53 patients were finalized and the clinical data of these patients were complete. Among them, 13 patients suffered from pulmonary infection after radical resection of colon cancer, and 40 patients had no obvious exacerbation and no complicated pulmonary infection. Results of logistic regression showed that, value of forced expiratory volume in 1 second/forced vital capacity （OR= 1.174, P=0.033）, operative time （OR= 1.638, P=0.012）, levels of postoperative copeptin （0R=1.328, P=0.032）, and procalcitonin （0R=1.465, P=0.042） were risk factors for pulmonary infection after radical resection of colon cancer. Receiver operating characteristic curve （ROC） showed that, operative time was 6.207-hour, postoperative copeptin level was 10.420 pmol/L, and the postoperative procalcitonin level was 3.676 ng/mL, which had the best predictive effect on predicting pulmonary infection after radical resection of colon cancer. Conclusions Value of forced expiratory volume in 1 second/forced vital capacity, operative time, levels of copeptin and procalcitonin after operation are the independent influencing factors for pulmonary infection after radical resection of colon cancer, and it has best prognostic outcome when the operative time is 6.207-hour, postoperative copeptin level is 10.420 pmol/L, and the postoperative procalcitonin level is 3.676 ng/mL.