肺超声评分预测肺癌根治术后心肺并发症

Lung ultrasound score predicts cardiopulmonary complications after radical lung cancer surgery

目的探讨肺癌根治术后心肺并发症的危险因素及肺超声评分对心肺并发症的预测价值。方法选择2022年6月至2022年12月上海市胸科医院胸外科择期行肺癌根治术的患者132例,根据术后心肺并发症发生情况分为并发症组(n=16)和无并发症组(n=116)。收集患者一般资料、手术相关信息及术后心肺并发症发生率。患者术前进行肺超声检查,采用12分区法,得出肺超声评分。采用多因素logistic回归分析心肺并发症发生的危险因素,采用ROC曲线构建肺超声评分对肺癌根治术后心肺并发症的预测模型。结果肺癌根治术后心肺并发症发生率为12.1%(16/132)。与无并发症组相比,并发症组男性患者比例更高(P=0.037)、年龄更大(P=0.002)、开放手术的比例更高(P=0.006)。两组患者的手术范围差异有统计学意义(P<0.001)。并发症组患者的肺超声评分显著高于无并发症组患者[(11.0±6.9)分vs(3.6±4.5)分,P=0.001)]。Logistic回归分析显示,手术范围及肺超声评分是影响术后心肺并发症的危险因素。ROC曲线显示,肺超声评分预测心肺并发症的截断值为12.5分,曲线下面积(area under the curve,AUC)为0.812(95%CI 0.687~0.938)。结论手术范围及肺超声评分是肺癌根治术后心肺并发症的危险因素。肺超声评分可以预测肺癌根治术后心肺并发症,评分>12.5分时发生心肺并发症的风险较大。

Objective To explore the risk factors of cardiopulmonary complications after radical lung cancer surgery and the predictive value of lung ultrasound score in postoperative cardiopulmonary complications.Methods A total of 132 patients who underwent elective radical resection of lung cancer in Shanghai Chest Hospital from June 2022 to December 2022 were selected.According to the occurrence of cardiopulmonary complications,patients were divided into the complication group(n=16)and the non-complication group(n=116).The general data,lung ultrasound score,operation related information and postoperative cardiopulmonary complications of the two groups were compared.A preoperative lung ultrasound examination was performed to obtain the lung ultrasound score through 12-zone method.Logistic regression analysis was used to determine the risk factors of postoperative cardiopulmonary complications,and the ROC curve was used to construct the predictive model of lung ultrasound score for the occurrence of postoperative cardiopulmonary complications after radical resection of lung cancer.Results The incidence of cardiopulmonary complications was 12.1%(16/132).There were statistically significant differences between the complication group and the non-complication group in age,gender,surgical method,surgical scope and lung ultrasound score(P<0.05).The total lung ultrasound scores in the complication group were significantly higher than those in the non-complication group([11.0±6.9]vs[3.6±4.5],P=0.001).Logistic regression analysis showed that surgical scope and lung ultrasound score were risk factors for cardiopulmonary complications.ROC curve analysis showed that the cutoff value of lung ultrasound score for predicting the occurrence of cardiopulmonary complications after radical lung cancer surgery was 12.5,and area under the curve(AUC)was 0.812(95%CI 0.687-0.938).Conclusions Surgical scope and lung ultrasound score are risk factors for cardiopulmonary complications after radical resection of lung cancer.Lung ultrasound score could predict postoperative cardiopulmonary complications,and the risk of complications is higher when the lung ultrasound score is greater than 12.5.