肺功能中度减退的肺癌患者术后并发症分析

背景与目的:随着肺癌开胸手术的深入开展,术前肺功能状况对手术的影响越来越受重视。本研究分析肺通气功能中度减退的肺癌患者术后并发症发生情况,探讨与并发症发生的相关因素。方法:同步对照分析肺通气功能中度减退(31例)与肺功能正常(62例)两组病例并发症的发生情况,进行t检验及卡方检验作比较,行logistic回归分析影响并发症出现的有关因素。结果:肺通气功能中度减退患者术后常见低氧血症(41.9%),心律失常或心功能不全(25.8%),肺部感染(25.8%)等一般并发症,呼吸衰竭、心力衰竭等严重并发症的发生率为9.2%,院内死亡率为3.2%;而对照组此4类并发症发生率分别为:16.1%、8.1%、9.6%及3.2%,无院内死亡。回归分析显示年龄、手术切除范围与并发症的发生相关。结论:肺通气功能中度减退的肺癌患者术后出现低氧血症等一般并发症几率较正常组明显增高,手术范围较局限的患者,严重并发症及院内死亡率并无明显增高,年龄越大、手术切除范围越大者并发症发生几率越大。

Postoperative complications in lung cancer patients with moderate pulmonary hypofunction

BACKGROUND & OBJECTIVE: With the development of surgery treatment for lung cancer, the importance of preoperative pulmonary function assessment evoked more and more attention. This research was set to analyze postoperative complications of lung cancer patients with moderate pulmonary hypofunction, and explore associated factors. METHODS: Statistic t test and Chi(2) test were used to compare postoperative complications of 31 patients with moderate pulmonary hypofunction and 62 patients with normal pulmonary function (control group), logistic regression was performed to find associated factors. RESULTS: In the 31 patients with moderate pulmonary hypofunction, hypoxemia (41.9%), arrhythmia or cardiac dysfunction (25.8%), pulmonary inflammation (25.8%) were common postoperative complications; incidence of severe complications, such as respiratory failure, and cardiac failure, was 9.2%; in-hospital mortality was 3.2%. In control group, the occurrence rates were 16.1%, 8.1%, 9.6%, and 3.2%, accordingly, no in-hospital death occurred. Regression analysis showed that age and resection range associated with the occurrence of postoperative complications. CONCLUSIONS: compared with control group, incidences of common postoperative complications in patients with moderate pulmonary hypofunction are remarkably increased, but severe complications and in-hospital mortality are not significantly high. Patients with older age and larger resection range have a high risk of develop complications.