早期非小细胞肺癌老年患者行肺叶切除术后心律失常的影响因素分析

Analysis of influencing factors of arrhythmia in senile patients with early non-small cell lung cancer after pulmonary lobectomy

目的探讨早期非小细胞肺癌老年患者行肺叶切除术后心律失常的影响因素。方法回顾性分析2018年12月—2019年12月于南阳市第二人民医院行肺叶切除术治疗的98例早期非小细胞肺癌老年患者的临床资料,将发生心律失常的29例患者纳入发生组,将未发生心律失常的69例患者纳入未发生组。比较两组一般资料,并将可能产生心律失常的影响因素纳入自变量并为其赋值,经非条件logistic回归分析,得出可能导致肺叶切除术后发生心律失常的危险因素。结果术后,98例患者中有29例(29.59%)患者出现心律失常,69例(70.41%)未出现心律失常;经logistic回归分析结果得出,吸烟史、迷走神经损伤、肺部感染、术中低血压均是影响肺叶切除术后发生心律失常的危险因素(OR=0.091、5.079、5.444、3.946,P<0.001、0.001、<0.001、0.008)。结论吸烟史、迷走神经损伤、肺部感染、术中低血压均会增加非小细胞癌老年患者肺叶切除术后发生心律失常的风险,因此需针对这些因素做好有效防护,以预防心律失常发生、提升手术效果。

Objective To investigate the influencing factors of arrhythmia in senile patients with early non-small cell lung cancer(NSCLC) after pulmonary lobectomy.Methods The clinical data of 98 senile patients with early NSCLC who underwent pulmonary lobectomy in the hospital from December 2018 to December 2019 were retrospectively analyzed. 29 patients with arrhythmia were included in the occurrence group, and 69 patients without arrhythmia were included in the non-occurring group. The general data of the two groups were compared, and the possible influencing factors of arrhythmia were included in the independent variables and assigned values. After unconditional logistic regression analysis, the risk factors that may cause arrhythmia after pulmonary lobectomy were obtained.Results After surgery, there were 29 cases(29.59%) of arrhythmia in 98 patients, and 69 cases(70.41%) had no arrhythmia;the logistic regression analysis showed that smoking history, vagus nerve injury, lung infection, and intraoperative hypotension were all risk factors affecting arrhythmia after lobectomy(OR=0.091, 5.079, 5.444, 3.946,P<0.001, 0.001, <0.001, 0.008).Conclusion Smoking history, vagus nerve injury, lung infection, and intraoperative hypotension will increase the risk of arrhythmias after pulmonary lobectomy in senile patients with NSCLC. Therefore, effective protection against these factors is needed to prevent the occurrence of arrhythmia and improve the effect of surgery.