795例肺癌术后发生心律失常危险因素的多因素回顾分析

目的]探讨肺癌术后发生心律失常的危险因素.方法]回顾分析795例肺癌手术患者,其中全肺切除术176例,肺叶切除术509例,楔型切除术110例.术后发生心律失常273例,应用Logistic回归分析影响术后发生心律失常可能的危险因素.结果]心律失常总发生率为34.3%（273/795）,多因素Logistic逐步回归分析显示高龄、吸烟史、心律失常史、全肺切除、术中心包损伤、术后肺不张是术后心律失常的主要危险因素（P＜0.05）,术后镇痛是保护因素（P=0.017）.结论]心脏储备功能的降低、对手术损伤及缺氧的耐受力降低是导致术后心律失常的原因,采取一些预防措施可以减少其发生率.

A Retrospective Multivariate Analysis on Risk Factors of Postoperative Cardiac Arrhythmia in 795 Cases with Lung Cancer

Purpose To investigate the risk factors of postoperative cardiac arrhythmia in lung cancer.Methods Logistic regression analysis with the risk factors of postoperative cardiac arrhythmia in 795 cases undergoing operation for lung cancer,those included 176 cases with pneumonectomy,509 cases with lobectomy and 110 cases with wedge resection.Two hundred and seventy-three cases occurred arrhythmia postoperation.Results The overall rate of arrhythmia was 34.3%(273/795).The risk factors including senility,history of smoking,arrhythmia,pneumonectomy,pericardiac injury during operation and postoperative pulmonary closure were identified by multifactor no-conditional logistic regression(P<0.05).The protective factor was postoperative analgesia(P=0.017).Conclusion The cause of arrhythmia are cardiac reserve function decreased surgical injury and decreased tolerance to hypoxia.Some prophylactic measure would reduce the occurrence of arrhythmia.