微创肺部手术后患者首次下床晕厥前兆预后因素的初步探索

Preliminary Exploration of Prognostic Factors of Syncope Precursor When Patients First Get Out of Bed After Minimally Invasive Pulmonary Surgery

目的探讨微创肺部手术后患者首次下床时发生晕厥前兆的预后因素。方法以2022年3~12月于我科行微创肺部手术的409例患者作为研究对象,术后首次下床出现低血压、头晕、大汗、恶心呕吐、黑矇、心悸中任意一项,即认定发生晕厥前兆。收集基本资料及手术相关指标,使用logistic回归分析发生晕厥前兆的预后因素。结果术后首次下床活动发生晕厥前兆94例(23.0%),未发生晕厥前兆315例(77.0%)。logistic回归分析显示术后1日胸腔引流量为晕厥前兆发生的独立预后因素,术后1日胸腔引流量>300 ml者发生晕厥前兆的风险是<200 ml者的2.377倍(95%CI:1.111~5.087,P=0.026)。结论微创肺部手术后患者首次下床活动出现晕厥前兆的发生率较高,术后1日胸腔引流量是发生晕厥前兆的独立预后因素,引流量>300 ml提示晕厥发生风险高,需要注意避免这些患者晕厥后跌倒所致伤害。

Objective To investigate the prognostic factors for the occurrence of syncope precursor when patients first get out of bed after minimally invasive lung surgery.Methods A total of 409 patients who underwent minimally invasive lung surgery in our department from March to December 2022 were selected.When patients first got out of bed at postoperation,occurrence of hypotension,dizziness,profuse sweating,nausea and vomiting,amaurosis,or palpitations was considered a syncope precursor.The basic data and surgery-related indicators were collected,and the logistic regression was utilized to analyze the prognostic factors for the occurrence of syncope precursor.Results When first got out of bed at postoperation,94 cases(23.0%)showed syncope precursors and 315 cases(77.0%)presented without syncope precursor.The logistic regression analysis showed that postoperative one-day chest drainage was an independent prognostic factor for developing syncope precursor.The risk of syncope precursor was 2.377 times higher in those with postoperative one-day chest drainage>300 ml than those with<200 ml(95%CI:1.111-5.087,P=0.026).Conclusions The incidence of syncope precursor in patients who first get out of bed after minimally invasive pulmonary surgery is high.Postoperative one-day chest drainage is an independent prognostic factor for syncope precursor,with drainage>300 ml indicating a high risk.Care needs to be taken to avoid injuries from falls after syncope in these patients.