Ⅰ、Ⅱ期非小细胞肺癌患者胸腔镜术后并发症发生的影响因素

Influencing Factors of the Occurence of Complications after Thoracoscopic Surgery in Patients with StageⅠandⅡNon-small Cell Lung Cancer

目的:研究Ⅰ、Ⅱ期非小细胞肺癌患者胸腔镜术后并发症发生的影响因素。方法:选取2017年3月-2018年9月厦门大学附属第一医院进行Ⅰ、Ⅱ期非小细胞肺癌治疗患者195例进行临床研究。所有患者均给予VATS肺叶切除术+系统淋巴结清扫术。按照术后患者是否出现并发症将患者分为并发症组和无并发症组。观察两组一般情况、病理情况、围手术期情况。统计分组情况,比较两组一般情况、病理情况、围手术期情况。对Ⅰ、Ⅱ期非小细胞肺癌患者胸腔镜术后并发症发生进行Logistic多因素回归分析。结果:195例患者中有42例出现术后并发症(并发症组),发生率为21.54%,153例未出现术后并发症(无并发症组)。并发症组年龄≥60岁、有吸烟史、合并COPD、冠心病占比均高于无并发症组(P<0.05)。并发症组Ⅱ期占比高于无并发症组(P<0.05)。并发症组手术时间长于无并发症组,术中失血量、术后第1天引流量均多于无并发症组,术后抗生素使用时间长于无并发症组(P<0.05)。Logistic结果提示有吸烟史、合并COPD、冠心病、病理分期、手术时间、术后第1天引流量均是Ⅰ、Ⅱ期非小细胞癌患者胸腔镜术后并发症发生的危险因素(P<0.05)。结论:对于有吸烟史、合并COPD、冠心病、分期为Ⅱ期、手术时间长、术后第1天引流量大的Ⅰ、Ⅱ期非小细胞癌患者,应注意胸腔镜术后并发症发生的风险。

Objective:To investigate the influencing factors of the occurence of complications after thoracoscopic surgery in patients with stage Ⅰ and Ⅱ non-small cell lung cancer.Method:A total of 195 patients with stage Ⅰ and Ⅱ non-small cell lung cancer treated in First Affiliated Hospital of Xiamen University from March 2017 to September 2018 were selected for clinical study.All patients were given VATS lobectomy+systematic lymph node dissection.Patients were divided into complication group and no complication group according to whether there were complications after surgery.The general condition,pathological condition and perioperative condition of the two groups were observed.The grouping situation was counted.The general condition,pathological condition and perioperative condition of the two groups were compared.Logistic regression analysis was used to analyze the occurence of complications after thoracoscopic surgery in patients with stage Ⅰ and Ⅱ non-small cell lung cancer.Result:A total of 42 patients in 195 patients had postoperative complications(complication group),the incidence rate was 21.54%,and 153 cases had no postoperative complications(non complication group).The proportions of age≥60 years old,have a smoking history,COPD and coronary heart disease in the complication group were higher than those in the non complication group(P<0.05).The proportion of stage Ⅱ in the complication group was higher than that in the non complication group(P<0.05).The surgery time in the complication group was longer than that in the non complication group,the intraoperative blood loss volume and the drainage volume on the first day after surgery were more than those in the non complication group,and the postoperative antibiotic use time was longer than that in the non complication group(P<0.05).The Logistic results showed that have a smoking history,COPD,coronary heart disease,pathological stage,surgery time and drainage volume on the first day after surgery were risk factors for the occurence of complications after thoracoscopic surgery in patients with stage Ⅰ and Ⅱ non-small cell lung cancer(P<0.05).Conclusion:For stage Ⅰ and Ⅱ non-small lung cancer patients with smoking history,COPD,coronary heart disease,stage Ⅱ,long surgery time and large drainage volume on the first day after surgery,we should pay attention to the risk of the occurence of complications after thoracoscopy surgery.