Ⅰ期肺癌病人胸腔镜术后继发持续性咳嗽因素分析

Analysis of factors contributing to postoperative persistent cough in early stage lung cancer patients

目的探讨Ⅰ期肺癌病人行胸腔镜手术术后并发持续性咳嗽(cough after pulmonary resection,CAP)的危险因素。方法2022年1月~2023年1月我院胸外科收治的Ⅰ期肺癌病人207例,收集病人性别、年龄、住院时间、吸烟时长、病理分期、手术侧别、是否清扫气管周围淋巴结、病理类型,手术方式(肺叶或肺段)、术前呼吸功能训练等临床病例资料。分别采用单因素和多因素Logistic回归分析CAP的影响因素。结果共有58例病人术后出现CAP,发生率为28.01%。单因素分析显示,吸烟时长、支气管树周围淋巴结清扫、手术方式以及术前呼吸训练CAP组与非CAP组比较,差异有统计学意义(P<0.05)。多因素分析显示,吸烟时长、清扫支气管树周围淋巴结、肺叶切除是CAP的危险因素(P<0.05),术前呼吸功能训练是其保护因素(P<0.05)。结论CAP的发生与吸烟时长、清扫支气管树周围淋巴结、手术方式有关,术前呼吸训练可降低CAP的发生率。

Objective To investigate the risk factors of persistent cough(cough after pulmonary resection,CAP)in patients with stage Ⅰ lung cancer after thoracoscopic surgery.Methods The clinical data of 207 patients with stage Ⅰ lung cancer who were admitted to the Department of Thoracic Surgery of Zhongnan Hospital of Wuhan University from January 2022 to January 2023 were retrospectively analyzed,including gender,age,length of hospital stay,smoking history,stage,left and right side of operation,and whether to dissect Lymph nodes around the trachea,pathological type,surgical method(lobe or segment),preoperative breathing training,etc.Univariate and multivariate Logistic regression were used to analyze the influencing factors of CAP.Results A total of 58 patients developed CAP after operation,the incidence rate was 28.01%(58/207).Univariate analysis showed that smoking duration,lymph node dissection around the bronchial tree,surgical method,and preoperative breathing training were associated with postoperative CAP(P<0.05).Multivariate analysis showed that smoking duration,lymph node dissection around the bronchial tree,and lobectomy were high risk factors for CAP(P<0.05).Preoperative breathing training was its protective factor(P<0.05).Conclusion The occurrence of CAP is related to the duration of smoking,the removal of lymph nodes around the bronchial tree,and the surgical method.Preoperative breathing training can effectively reduce the incidence of CAP.