胸腔镜肺切除术后持续咳嗽的多因素分析

发布时间：2018-10-04 18:30

【摘要】：目的探讨胸腔镜肺切除术后持续咳嗽(cough after pulmonary resection,CAP)发生的预后因素。方法回顾性分析2014年4月~2016年3月我科650例肺癌胸腔镜肺切除术的临床资料,根据术后是否发生持续咳嗽分为CAP组和非CAP组,单因素分析包括性别、年龄、吸烟史、病理类型、纵隔淋巴结转移、手术侧(左侧或右侧)、手术肺叶(上叶或非上叶)、手术方式、淋巴结切除方式、气管树周围淋巴结切除、离断下肺韧带、出院时合并气胸、出院时合并胸水,采用logistic回归进行多因素分析。结果术后发生CAP 175例,占26.9%。单因素分析显示,年龄、吸烟史、手术侧、切除肺叶、气管树周围淋巴结切除、出院时合并气胸有统计学差异(P0.05)。多因素回归分析显示,年龄(OR=0.616,95%CI:0.424~0.895,P=0.011)、吸烟史(OR=0.656,95%CI:0.432~0.997,P=0.048)、手术侧(OR=1.814,95%CI:1.241~2.652,P=0.002)、切除肺叶(OR=1.789,95%CI:1.214~2.636,P=0.003)、气管树周围淋巴结切除(OR=2.730,95%CI:1.126~6.622,P=0.026)是CAP发生的预后因素。结论持续咳嗽是胸腔镜肺切除术后的常见并发症之一。年龄63岁、无吸烟史、右侧手术、上叶手术、有气管树周围淋巴结切除的患者更易发生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.
【作者单位】：北京大学人民医院胸外科;
【基金】：首都卫生发展科研专项项目(项目编号:首发2014-1-4081)
【分类号】：R734.2

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