急诊就诊晚期肺癌的临床特征及患者死亡影响因素分析

Analysis of Clinical Characteristics and Death Factors of Patients with Advanced Lung Cancer in Emergency Treatment

目的探讨急诊就诊晚期肺癌的临床特征及患者死亡的影响因素。方法选取急诊就诊晚期肺癌患者83例,收集患者年龄、性别、病理类型、急诊原因、预后情况和D-聚体(D-D)、白细胞介素-6(IL-6)、血乳酸等信息,分析急诊就诊晚期肺癌患者的临床特征和急诊后3个月内死亡的危险因素。结果急诊就诊的晚期肺癌患者中,男性占比67.47%,女性占比32.53%;年龄<60岁占比37.35%,≥60岁占比62.65%;腺癌占比59.04%,鳞癌占比21.69%,小细胞癌占比19.28%;急诊原因以肺部感染(62.65%)、呼吸衰竭(55.42%)、意识障碍(22.89%)为主;急诊后3个月内死亡率为63.86%。白细胞、白蛋白、D-D、IL-6、血乳酸水平和是否合并呼吸衰竭、肺部感染、贫血、电解质紊乱为晚期肺癌患者急诊后3个月内死亡的影响因素(P<0.05);logistic回归分析显示,白细胞升高、白蛋白降低、D-D升高、IL-6升高、血乳酸升高、呼吸衰竭、肺部感染、贫血、电解质紊乱是晚期肺癌患者急诊后3个月内死亡的危险因素(P<0.05)。结论急诊就诊晚期肺癌患者预后差,急诊后3个月内死亡率高,临床可结合患者死亡的危险因素,实施针对性干预措施,以延长患者生存期,提高预后效果。

Objective To analyze the clinical characteristics and death factors of patients with advanced lung cancer.Methods 83 patients with advanced lung cancer were selected,to collect information on patient years,sex,pathological type,emergency cause,prognosis and D-polymer(D-D),interleukin-6(IL-6),blood lactic acid,To analyze the clinical characteristics of patients with advanced lung cancer and the risk factors of death within 3 months after emergency treatment.Results In patients with advanced lung cancer,67.47 per cent men,32.53 per cent women;Age<60,37.35%,62.65%of≥aged 60;Adenocarcinoma accounts for 59.04%,21.69%of squamous cell carcinoma,Small cell carcinoma accounted for 19.28%;The main causes of emergency were pulmonary infection(62.65%),respiratory failure(55.42%)and disturbance of consciousness(22.89%);The mortality rate was 63.86%within 3 months after emergency.Leukocyte,albumin,D-D、IL-6、lactate level and whether or not combined with respiratory failure,pulmonary infection,anemia,electrolyte disturbance were the influencing factors of death in patients with advanced lung cancer within 3 months after emergency(P<0.05);logistic regression analysis showed,Leukocyte elevation,albumin reduction,D-D elevation,IL-6 elevation,elevated blood lactate,respiratory failure,pulmonary infection,anemia,electrolyte disturbance were risk factors for death in patients with advanced lung cancer within 3 months after emergency(P<0.05).Conclusion The prognosis of patients with advanced lung cancer in emergency department is poor and the mortality rate is high within 3 months after emergency.The clinical intervention measures can be carried out in combination with the risk factors of death in order to prolong the survival time and improve the prognosis effect.