CAJ | 학술논문

目的：探讨超高龄肺癌患者围术期心律失常的常见危险因素及防治措施。方法选取125例75～86岁的超高龄肺癌患者作为观察组，同时选取100例年龄45～65岁的肺癌患者作为对照组，2组患者均采用全肺切除或肺叶切除，观察并比较2组患者围手术期心律失常发生情况。结果观察组患者72例（57．60％）发生心律失常，对照组35例（35．00％）发生心律失常，2组差异有统计学意义（P＜0．05）。超高龄患者术后心律失常多因素Logistic回归分析，确定心肺合并症、二氧化碳分压及手术范围是显著的三大独立危险因素。肺癌术后心律失常的手术相关因素中有手术切除方式及手术时间。全肺切除术后心律失常的发生率最高，而肺叶切除术后心律失常的发生率则较低。其它因素如性别、肿瘤病变部位、淋巴结清扫及清扫之淋巴结有无阳性则与高龄肺癌患者术后发生心律失常无相关性。结论年龄、心肺功能差、术式及低血容量等是引起超高龄肺癌患者围术期心律失常的危险因素，应做好相应的预防护理措施，减少心律失常的发生。
목적：탐토초고령폐암환자위술기심률실상적상견위험인소급방치조시。방법선취125례75～86세적초고령폐암환자작위관찰조，동시선취100례년령45～65세적폐암환자작위대조조，2조환자균채용전폐절제혹폐협절제，관찰병비교2조환자위수술기심률실상발생정황。결과관찰조환자72례（57．60％）발생심률실상，대조조35례（35．00％）발생심률실상，2조차이유통계학의의（P＜0．05）。초고령환자술후심률실상다인소Logistic회귀분석，학정심폐합병증、이양화탄분압급수술범위시현저적삼대독립위험인소。폐암술후심률실상적수술상관인소중유수술절제방식급수술시간。전폐절제술후심률실상적발생솔최고，이폐협절제술후심률실상적발생솔칙교저。기타인소여성별、종류병변부위、림파결청소급청소지림파결유무양성칙여고령폐암환자술후발생심률실상무상관성。결론년령、심폐공능차、술식급저혈용량등시인기초고령폐암환자위술기심률실상적위험인소，응주호상응적예방호리조시，감소심률실상적발생。
Objective To study the risk factors of perioperative arrhythmia in over-aged patients with lung cancer and preventive measures.Methods Patients with lung cancer aged 75~86 years as the observation group,and 100 patients with lung cancer aged 45~65 years as the control group,all patients received pneumonectomy or lobectomy,perioperative arrhythmia be-tween the 2 groups were compared.Results In the observation group,72 cases (57.60%) had arrhythmia,in the control group, 35 cases (35.00%) had arrhythmia,there had significant difference (P<0.05).Postoperative arrhythmias multivariate logistic regression analysis showed that cardiopulmonary complications,carbon dioxide partial pressure and the extent of surgery were in-dependent risk factors.Postoperative arrhythmias lung univariate analysis showed that among surgery-related factors,surgical meth-od and surgical time>4 h had statistical significance,the whole lung resection had highest incidence of arrhythmia,and lobectomy had a lower incidence of arrhythmia.Other factors such as gender,tumor lesions,lymph node dissection positive or not had no cor-relation with the occurrence of cardiac arrhythmia in the over-aged lung cancer patients.Conclusion Age,poor heart and lung function,hysterectomy and low blood volume and postoperative pain are risk factors for arrhythmia in the over-aged lung cancer patients.Corresponding preventive care measures should be prepared to reduce the occurrence of arrhythmia.