目的分析胸腔镜手术治疗老年肺结节患者术后肺部并发症的影响因素及对远期预后的影响。方法对910例老年肺结节患者行胸腔镜手术治疗,分析术后1个月肺部并发症发生的影响因素。采用Kaplan-Meier生存曲线分析患者术后并发症对远期预后的影响。结果910例老年肺结节患者术后肺部并发症发生率为17.58%。多因素logistic回归分析结果表明,高龄、手术时间长、肺结节直径大、美国麻醉医师协会分级高和未使用抗菌药物为胸腔镜术后肺部并发症发生的独立危险因素(P<0.05)。632例肺癌患者胸腔镜术后发生肺部并发症136例(21.52%),均完成5年随访,结果显示未发生肺部并发症肺癌患者生存率高于发生肺部并发症患者(P<0.05)。结论胸腔镜手术治疗老年肺结节患者的术后肺部并发症发生率不容忽视,应根据可能的影响因素采取有效措施干预,提高患者远期预后。Objective To analyze the influencing factors and long-term prognosis of postoperative pulmonary complications in elderly patients with pulmonary nodules treated by thoracoscopic surgery.Methods Thoracoscopic surgery was performed in 910 elderly patients with pulmonary nodules,and the influencing factors of pulmonary complications about one month after operation were analyzed.Kaplan-Meier survival curve was used to analyze the influence of postoperative complications on the long-term prognosis.Results The incidence rate of postoperative pulmonary complications in 910 elderly patients with pulmonary nodules was 17.58%.Multivariate logistic regression analysis showed that older age,longer operation time,larger lung nodule diameter,higher ASA grade and no antibiotics use were the independent risk factors for the occurrence of postoperative pulmonary complications(P<0.05).Pulmonary complications occurred in 136 cases(21.52%)of lung cancer patients after thoracoscopic surgery,whom were all followed up for 5 years.The survival rate of patients with lung cancer without pulmonary complications was higher than that of those with pulmonary complications(P<0.05).Conclusion The occurrence of postoperative pulmonary complications in elderly patients with pulmonary nodules underwent thoracoscopic surgery can not be ignored and effective measures should be taken according to possible influencing factors to improve the long-term prognosis.
机构地区中国人民武装警察部队海警总队医院胸外科
出处《江苏医药》 CAS 2021年第1期48-51,共4页Jiangsu Medical Journal
