肺癌患者胸腔镜下肺段切除与肺叶切除术后房颤发生率的比较

Incidence of Postoperative Atrial Fibrillation in Lung Cancer Patients Undergoing Thoracoscopic Segmentectomy or Lobectomy

目的:比较肺癌患者在胸腔镜下不同手术方式后房颤发生率的区别,探索肺癌术后房颤发生的影响因素。方法:比较2018年6月1日至2020年6月1日期间我院胸腔外科同一手术组不同手术方式后肺癌患者房颤的发生率。结果:325名患者符合入组条件,其中肺叶切除组患者212例,肺段切除组113例,共有21例患者术后出现房颤,其中肺叶切除组18名(8.49%),肺段切除组3名(2.65%)。房颤患者的平均年龄(P=0.034)、术前一秒率(第一秒呼出气占用力肺活量的比值,FEV1/FVC;P=0.001)、淋巴结清扫方式(P=0.036)以及手术时间(P=0.043)与无房颤患者相比,差异有统计学差异(P<0.05),经多因素Logistic回归分析,手术方式、FEV1/FVC≤70%和手术时间是术后房颤发生的影响因素(P<0.05)。结论:与肺叶切除术相比,行肺段切除的肺癌患者的房颤发生率显著降低,患者的术前肺功能、手术时间是肺癌患者术后房颤发生的影响因素。

Objective:To compare the incidence of postoperative atrial fibrillation(POAF)in different surgical groups,and elucidate its influencing factors.Methods:Incidences of POAF in lung cancer patients after different surgical methodsbe-tween June 1,2018 and June 1,2020 were compared.Results:Of the 325 patients,212 underwent lobectomy,and 113 underwent segmentectomy.POAF was observed in 21 patients.Of those patients,18(8.49%)were in the lobectomy group,and 3(2.65%)in the segmentectomy group.Age(P=0.034),preoperative FEV1/FVC ratio(P=0.001),mode of lymph node dissection(P=0.036),and operation time(P=0.043)were significantly different between patients with and without POAF.Multivariate logistic regression analysis showed that operation mode,FEV1/FVC ratio≤70%and operation time were the influencing factors of POAF(P<0.05).Conclusion:The incidence of POAF is significantly lower by segmentectomy than that by lobectomy.Preoperative pulmonary function and surgical time are the factors affecting the occurrence of POAF in lung cancer patients.