發(fā)布時(shí)間：2018-10-04 18:30

【摘要】：目的探討胸腔鏡肺切除術(shù)后持續(xù)咳嗽(cough after pulmonary resection,CAP)發(fā)生的預(yù)后因素。方法回顧性分析2014年4月~2016年3月我科650例肺癌胸腔鏡肺切除術(shù)的臨床資料,根據(jù)術(shù)后是否發(fā)生持續(xù)咳嗽分為CAP組和非CAP組,單因素分析包括性別、年齡、吸煙史、病理類(lèi)型、縱隔淋巴結(jié)轉(zhuǎn)移、手術(shù)側(cè)(左側(cè)或右側(cè))、手術(shù)肺葉(上葉或非上葉)、手術(shù)方式、淋巴結(jié)切除方式、氣管樹(shù)周?chē)馨徒Y(jié)切除、離斷下肺韌帶、出院時(shí)合并氣胸、出院時(shí)合并胸水,采用logistic回歸進(jìn)行多因素分析。結(jié)果術(shù)后發(fā)生CAP 175例,占26.9%。單因素分析顯示,年齡、吸煙史、手術(shù)側(cè)、切除肺葉、氣管樹(shù)周?chē)馨徒Y(jié)切除、出院時(shí)合并氣胸有統(tǒng)計(jì)學(xué)差異(P0.05)。多因素回歸分析顯示,年齡(OR=0.616,95%CI:0.424~0.895,P=0.011)、吸煙史(OR=0.656,95%CI:0.432~0.997,P=0.048)、手術(shù)側(cè)(OR=1.814,95%CI:1.241~2.652,P=0.002)、切除肺葉(OR=1.789,95%CI:1.214~2.636,P=0.003)、氣管樹(shù)周?chē)馨徒Y(jié)切除(OR=2.730,95%CI:1.126~6.622,P=0.026)是CAP發(fā)生的預(yù)后因素。結(jié)論持續(xù)咳嗽是胸腔鏡肺切除術(shù)后的常見(jiàn)并發(fā)癥之一。年齡63歲、無(wú)吸煙史、右側(cè)手術(shù)、上葉手術(shù)、有氣管樹(shù)周?chē)馨徒Y(jié)切除的患者更易發(fā)生CAP。
[Abstract]:Objective to investigate the prognostic factors of persistent cough (cough after pulmonary resection,CAP) after thoracoscopic pneumonectomy. Methods the clinical data of 650 patients with lung cancer undergoing thoracoscopic pneumonectomy from April 2014 to March 2016 were retrospectively analyzed. The patients were divided into CAP group and non-CAP group according to the occurrence of persistent cough. Univariate analysis included sex, age, smoking history and pathological type. Mediastinal lymph node metastasis, surgical side (left or right), operative lobes (upper lobe or non-upper lobe), surgical procedure, lymph node resection, peritracheal lymph node resection, subtracheal ligament dissection, discharge with pneumothorax, discharge with pleural effusion, Multivariate analysis was carried out by logistic regression. Results CAP occurred in 175 cases (26.9%). Univariate analysis showed that age smoking history surgical side resection of lung lobe resection of peritracheal lymph nodes were statistically different when discharged with pneumothorax (P0.05). Multivariate regression analysis showed that age (OR=0.616,95%CI:0.424~0.895,P=0.011), smoking history (OR=0.656,95%CI:0.432~0.997,P=0.048), operative side (OR=1.814,95%CI:1.241~2.652,P=0.002), resection of pulmonary lobes (OR=1.789,95%CI:1.214~2.636,P=0.003) and peritracheal lymphadenectomy (OR=2.730,95%CI:1.126~6.622,P=0.026) were prognostic factors of CAP. Conclusion continuous cough is one of the common complications after thoracoscopic pneumonectomy. CAP. was more likely in 63 years old patients with no smoking history, right surgery, upper lobe surgery and peritracheal lymphadenectomy.
【作者單位】： 北京大學(xué)人民醫(yī)院胸外科;
【基金】：首都衛(wèi)生發(fā)展科研專(zhuān)項(xiàng)項(xiàng)目(項(xiàng)目編號(hào):首發(fā)2014-1-4081)
【分類(lèi)號(hào)】：R734.2

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