肺年龄对食管癌术后肺炎的影响

Influence of lung age on postoperative pneumonia after esophageal cancer surgery

目的探讨食管癌术后肺炎的影响因素及肺年龄与食管癌术后肺炎的相关性。方法我们回顾性分析了从2016年1月-2020年12月南京医科大学附属常州第二人民医院接受食管癌根治手术的396例患者的临床数据,根据患者肺功能计算肺年龄。我们用单因素分析肺年龄、性别、高龄、吸烟、术前高血压、术前糖尿病、新辅助治疗、肺功能、手术时长、手术方式、术中出血、病理类型、食管癌分段与食管癌术后肺炎的关系,并用多因素回归分析食管癌术后肺炎的高危因素。结果食管癌患者术后肺炎的发生率为38.1%。在单因素分析中,性别(P=0.000)、高龄(P=0.037)、吸烟(P=0.000)、手术时长(P=0.029)、手术方式2(P=0.004)、肺年龄(P=0.001)、食管癌分段(P=0.022)及病理类型(P=0.013)与食管癌术后肺炎有关,而在多因素回归分析中,肺年龄(P=0.047)、高龄(P=0.005)、性别(P=0.004)、吸烟(P=0.006)是食管癌术后肺炎的独立危险因素。结论肺年龄、性别、高龄、吸烟是食管癌术后肺炎的独立危险因素。肺年龄与实际年龄差值越大,肺炎发生率越高。在临床上或许可通过术前计算肺年龄筛选出食管癌术后发生肺炎的高危患者,从而采取措施减少肺炎的发生。

Objective To investigate the related influencing factors of postoperative pneumonia after esophageal cancer surgery and the correlation between lung age and the postoperative pneumonia.Methods We retrospectively analyzed the data of 396 patients who underwent esophageal cancer surgery in our hospital from January 2016 to December 2020,and calculated lung age according to lung function.We used univariate analysis of lung age,gender,advanced age,smoking,preoperative hypertension,preoperative diabetes,neoadjuvant therapy,lung function,surgical duration,operative method,intraoperative bleeding,histology,esophageal cancer staging and the relationship with postoperative esophageal cancer pneumonia,and multivariate regression analysis of the risk factors for postoperative esophageal cancer pneumonia.Results The incidence of postoperative pneumonia in patients after esophageal cancer surgery was 38.1%.In univariate analysis,gender(P=0.000),advanced age(P=0.037),smoking(P=0.000),operative duration(P=0.029),operative method 2(P=0.04),lung age(P=0.001),esophageal cancer staging(P=0.022)and pathological type(P=0.013)were associated with pneumonia after esophageal cancer surgery.In multivariate regression analysis,lung age(P=0.047),advanced age(P=0.005),gender(P=0.004)and smoking(P=0.006)were independent risk factors for pneumonia after esophageal cancer surgery.Conclusion Lung age,sex,advanced age and smoking are independent risk factors for pneumonia after esophageal cancer surgery.The greater the difference between lung age and actual age,the higher the incidence of pneumonia.Considering the relationship between lung age and pneumonia after esophageal cancer surgery,we may select high-risk patients with pneumonia after esophageal cancer surgery by preoperative calculation of lung age in clinical practice,so as to take measures to reduce the occurrence of pneumonia.