CAJ | 학술논문

目的调查研究70岁以上老年肺癌患者全胸腔镜手术切除后并发症发生及其影响因素,探讨其在预测并发症发生中的价值,以指导围术期处理,提高手术安全性.方法分析2009年3月至2013年3月接受全胸腔镜手术治疗的70岁以上380例肺癌患者的临床资料,分析其并发症,并对可能与术后并发症发生相关的因素进行单因素及多因素Logistic回归分析.结果本组死亡率为3.16％(12/380).术后并发症发生率为36.30％(137/380),包括心律失常、肺部感染、肺不张、脓胸、呼吸衰竭、切口感染、胸腔出血、心肌梗死、声音嘶哑、支气管胸膜瘘、肺栓塞、乳糜胸、心力衰竭等.采用多因素Logistic回归分析发现:年龄＞75岁是70岁以上肺癌全胸腔镜手术后并发症发生的独立危险因素[P＜0.01,比值比(OR)=2.525].结论 75以下老年肺癌患者胸腔镜手术较安全、有效,年龄超过75岁患者并发症明显增加.
목적 조사연구70세이상노년폐암환자전흉강경수술절제후병발증발생급기영향인소,탐토기재예측병발증발생중적개치,이지도위술기처리,제고수술안전성.방법 분석2009년3월지2013년3월접수전흉강경수술치료적70세이상380례폐암환자적림상자료,분석기병발증,병대가능여술후병발증발생상관적인소진행단인소급다인소Logistic회귀분석.결과 본조사망솔위3.16％(12/380).술후병발증발생솔위36.30％(137/380),포괄심률실상、폐부감염、폐불장、농흉、호흡쇠갈、절구감염、흉강출혈、심기경사、성음시아、지기관흉막루、폐전새、유미흉、심력쇠갈등.채용다인소Logistic회귀분석발현:년령＞75세시70세이상폐암전흉강경수술후병발증발생적독립위험인소[P＜0.01,비치비(OR)=2.525].결론 75이하노년폐암환자흉강경수술교안전、유효,년령초과75세환자병발증명현증가.
Objective To analyze the risk factors correlated to postoperative complications of video-assisted thoracoscopy for lung cancer elderly patients aged 70 years and over,aiming to study their predictive value on video-assisted thoracic surgical safety and guide the perioperative treatment and increase the safety of surgery.Methods The clinical experience of 380 lung cancer patients aged 70 years and over undergone video-assisted thoracic surgery from March 2009 to March 2013 were retrospectively study.The risk factors which closely related to the occurrence of postoperative complications were analyzed by univariate and multivariate statistical analysis with logistic regression.Results Operative mortality was 3.16％ (12 patients) and morbidity was 33.60％ (137 patients),including pulmonary infection,pulmonary atelectasis,arrhythmia,pulmonary air leak,respiratory function failure,thoracic bleeding,empyema,chylothorax,hoarseness,incision infection,myocardial infarction,pulmonary embolism,bronchial fistula,heart failure,etc.Multivariate statistical analysis with logistic regression demonstrated that the risk factors which closely related to the occurrence of postoperative complications were age over 75 years (OR =2.525,P ＜0.01).Conclusion Video-assisted thoracoscopy for lung cancer in elderly patients under 75 years old was safe and efficient.Age over 75 in this population increased the risk of complications.