老年肺癌患者术前心率恢复异常与术后心肺并发症关系的研究

目的研究老年患者术前心率恢复(HRR)异常与术后心肺并发症的相关性及术后并发症发生的危险因素分析。方法选取我院110例年龄>60岁的原发性肺癌患者的临床资料,根据术前HRR是否正常分为HRR正常组与HRR异常组,分析HRR与术后心肺相关并发症间关系;根据术后是否发生心肺并发症分为有并发症组与无并发症组,分析术后心肺并发症发生的相关危险因素。结果共分析110例老年肺癌患者临床数据,HRR异常组38例,HRR正常组72例;术后心肺并发症发生39例,HRR异常组19例,HRR正常组20例。HRR正常组并发症发生率27.78%,显著低于HRR异常组50.00%(P<0.05);单因素分析吸烟史、手术切除范围、手术时间,有统计学差异(P<0.05);6分钟步行试验指标中血压、血氧饱和度、6分钟步行距离、呼吸困难评分、心率,无明显统计学差异(P>0.05);多因素分析吸烟史、单肺叶切除术及扩大或全肺切除、手术时间、HRR异常,为术后发生并发症的危险因素(P<0.05)。结论HRR异常可增加老年肺癌患者术后心肺相关并发症的发生;吸烟史、单肺叶切除、扩大或全肺叶切除、手术时间过长、HRR异常是老年肺癌患者术后心肺相关并发症发生的危险因素。

Relationship between heart rate recovery and postoperative cardiopulmonary complications in elderly patients with lung cancer

Objective To study the correlation between heart rate recovery(HRR)and postoperative cardiopulmonary complications in elderly patients with lung cancer and the risk factors of postoperative cardiopulmonary complications.Methods The clinical data of 110 patients with primary lung cancer aged>60 years old in our hospital were selected.The relationship between HRR and postoperative cardiopulmonary complications and the risk factors of postoperative cardiopulmonary complications were analyzed.Results The clinical data of 110 elderly patients with lung cancer were analyzed,including 38 abnormal HRR cases and 72 normal HRR cases.There were 39 postoperative cardiopulmonary complications,19 in the HRR abnormal group and 20 in the HRR normal group.The incidence of complications in the HRR normal group was 27.78%,significantly lower than 50.00%in the HRR abnormal group(P<0.05).Univariate analysis showed that there were significant differences in smoking,surgical resection scope and operation time(P<0.05).There was no significant difference in blood pressure,blood oxygen saturation,6-minute walking distance,dyspnea score and heart rate in 6-minute walk test(6 MWT)between the two groups(P>0.05).Multivariate analysis showed that smoking,single pulmonary lobectomy and extended or total pneumonectomy,operation time and abnormal HRR were the risk factors of postoperative complications(P<0.05).Conclusion HRR abnormality can increase the incidence of cardiopulmonary complications in elderly patients with lung cancer.Smoking,single pulmonary lobectomy,extended or total lobectomy,long operation time and HRR abnormality are the risk factors of postoperative cardiopulmonary complications in elderly patients with lung cancer.