老年胃癌患者术后肺部并发症危险因素分析及防治策略

目的:回顾性分析老年患者胃癌根治术后肺部并发症（postoperative pulmonary complications,PPC）的危险因素，并探讨PPC的预防与治疗措施。方法:回顾性分析2014年05月至2020年04月于我院行胃癌根治术的196例65岁以上老年患者的临床资料。统计PPC的发生情况，对可能影响PPC发生的因素进行单因素分析和多因素Logistic回归分析。结果:196例患者行胃癌根治术，有24例出现PPC，PPC的发生率为12.2%。单因素分析显示，年龄≥75岁、体质量指数（body mass index，BMI）≥28 kg/m2、长期吸烟史、合并呼吸系统疾病、开腹手术、术后胃管留置时间≥5 d与老年胃癌患者PPC的发生相关（P＜0.05）。多因素 Logistic 回归分析显示，合并呼吸系统疾病是PPC发生的独立危险因素（OR=37.291，P＜0.05）。结论:合并呼吸系统疾病是老年胃癌患者PPC发生的独立危险因素。针对罹患呼吸系统基础疾病的老年胃癌患者，应采取合理的预防及治疗措施，以期减少PPC的发生。

Risk factors and prevention strategies of postoperative pulmonary complications in elderly patients after radical gastrectomy

Objective:To analyze the risk factors of postoperative pulmonary complications（PPC) in elderly patients after radical gastrectomy,and to explore the prevention and treatment of PPC.Methods:The clinical data of 196 patients over 65 years old who underwent radical gastrectomy in our hospital from May 2014 to April 2020 were analyzed retrospectively.Record the occurrence of PPC.The influencing factors of PPC were analyzed by univariate analysis and multivariate logistic regression.Results:Of the 196 cases,24 patients occurred PPC（12.2%).Univariate analysis showed that age ≥75 years,body mass index(BMI)≥28 kg/m2,long term smoking history,respiratory diseases,open surgery,postoperative gastric tube retention time ≥5 d related to PPC after radical gastrectomy（P＜0.05).Multivariate analysis showed that respiratory disease（OR=37.291,P＜0.05) was an independent risk factor of PPC after radical gastrectomy.Conclusion:Respiratory disease is an independent risk factor for PPC after radical gastrectomy in elderly patients with gastric cancer.For high-risk patients,we should take reasonable prevention and treatment measures to reduce the incidence of PPC.