肺切除术后不可耐受性咳嗽的危险因素分析

目的 探讨肺切除术后发生不可耐受性咳嗽（ICAP）的危险因素。方法 回顾性队列研究。纳入蚌埠医学院第一附属医院2019年1—12月行肺切除术的365例患者的临床资料,男211例、女154例,年龄24~83岁。根据术后是否出现ICAP,将患者分为ICAP组61例和非ICAP组304例。患者肺切除术后出现ICAP的危险因素分析采用单因素分析和多因素logistic回归分析。结果 单因素分析结果显示：2组患者性别、吸烟史、气管树周围淋巴结切除、术前咳嗽及手术侧别的差异均有统计学意义（χ²=8.50、15.25、12.15、4.20、4.95,P值均<0.05）。多因素logistic回归分析结果显示：女性、无吸烟史、右肺手术、气管树周围淋巴结切除,以及术前咳嗽,均为术后ICAP的独立危险因素（优势比=4.036、6.243、2.311、3.347、1.953,95%可信区间为2.077~7.845、3.030~12.864、1.184~4.512、1.732~6.467、1.039~3.668,P值均<0.05）。结论 女性、无吸烟史、右肺手术、气管树周围淋巴结切除以及术前咳嗽可能会导致肺切除术后ICAP的发生,是其独立危险因素。

Analysis of risk factors of intolerable cough after pneumonectomy

Objective To explore the risk factors of intolerable cough after pneumonectomy (ICAP). Methods A retrospective cohort study was conducted. The clinical data of 365 patients who underwent pneumonectomy in the First Affiliated Hospital of Bengbu Medical College from January to December 2019 were included. There were 211 males and 154 females aged 24-83 years old. According to the occurrence of ICAP after operation, the patients were divided into the ICAP group (61 patients) and non-ICAP group (304 patients). Univariate analysis and multivariate logistic regression analysis were used to explore the risk factors of ICAP after pneumonectomy. Results Univariate analysis showed that there were significant differences in gender, smoking history, lymph node resection around the tracheal tree, preoperative cough, and surgical side between the two groups (χ²=8.50, 15.25, 12.15, 4.20, 4.95, respectively; all P values < 0.05). Multivariate logistic regression analysis showed that gender, smoking history, operation side, peritracheal tree lymph node resection, and preoperative cough were independent risk factors for ICAP (odds ratio=4.036, 6.243, 2.311, 3.347, 1.953; 95% confidence interval 2.077-7.845, 3.030-12.864, 1.184-4.512, 1.732-6.467, 1.039-3.668, respectively; all P values <0.05). Conclusion Gender, smoking history, operation side, peritracheal tree lymph node resection, and preoperative cough were risk factors for ICAP.