目的:探讨食管癌术后肺部并发症(postoperative pulmonary complications,PPC)的特点及影响其发生的危险因素。方法:对南京医科大学第一附属医院胸心外科2014年3月至2015年5月295例行食管癌手术患者进行回顾性分析,根据围手术期有无肺并发症发生分为PPC组和正常组,对患者的临床资料先进行单因素分析筛选,将有意义的变量再进行多因素回归分析。结果:①两组患者术后患者住院期间肺部并发症发生率为12.9%。②单因素分析显示:PPC组与正常组在年龄、体重、吸烟、肺功能(FEV1)、术中液入量正平衡比较差异有统计学意义(P均<0.05)。③对上述五项指标行Logistic多因素回归分析显示:年龄> 70岁(OR=14.43,P<0.05)、吸烟指数>400(OR=12.21,P<0.01)、体重指数<18kg/ m2(OR=15.74,P<0.01)与肺部并发症发生明显相关。结论:肺部并发症是食管癌术后最常见的并发症,年龄> 70岁、吸烟、低体重是围手术期肺部并发症发生的危险因素。
Objectives:To analyze the features and risk factors of Postoperative Pulmonary Complications of Esophageal Carcinoma.Methods:A total of 295patients who received esophagectomy between March 2014 and May 2015 were included in the study. The patients were assigned into PPC(postoperative pulmonary complications)group and normal group, and postoperative factors were collected and analyzed between two groups, and the multivariate analysis (Logistic regression) were use to identify the risk factors of PPC. Conclusions:①No cases of death occurred in the two groups. The over incidence of PPC was 12.9%(38/295).②Univariate analysis revealed that there were significant differences in age,weight,smoking, preoperative pulmonary function, volume overload(all P<0.05). ③Three variables were found to be significantly related to the development of PPC by multivariate analysis: age(OR=8.71,P<0.05), smoking(OR=12.21 P<0.01), weight(OR=14.43,P<0.01). Results:PPC is a serious complication after esophagectomy. This study shows that age>70 years, smoking and emaciation are risk factors most likely associated with PPC development.