应用Clavien-Dindo分级系统对肺癌患者术后并发症分级及危险因素分析

发布时间：2019-03-30 16:44

【摘要】：背景与目的术后并发症是肺切除术后患者死亡的重要原因。在本研究中,我们应用Clavien-Dindo并发症分级系统对肺癌术后并发症按照严重程度进行分级,并分析术后并发症的发生率,探讨不同分级术后并发症的危险因素。方法回顾性分析2013年6月-2014年12月四川大学华西医院胸外科966例行肺叶切除术的肺癌患者,依据术后30 d内是否发生并发症将此966例患者分为并发症组与无并发症组;同时根据Clavien-Dindo分级系统将并发症分为4级,并针对不同分级的并发症进行危险因素分析。结果 966例患者中,并发症组占15.0%(145/966),发生总数380次;依据Clavien-Dindo分级系统将此380次并发症进行分级,其中I级、II级、III级、IV级及以上分别占6.8%、75.3%、15.0%和2.9%。Logistic回归分析结果显示术前第1秒用力呼气容积(forded expiratory volume in one second,FEV1)、肺一氧化碳弥散量(dif usion capacity for carbon monoxide of the lung single breath,DLco SB)及术前合并慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)是术后并发症的独立危险因素;其中术前FEV1是I级、II级、III级及以上并发症的独立危险因素。结论在Clavien-Dindo分级系统下,II级并发症在术后30天内最常见;FEV1与术后并发症的发生密切相关,可作为评估术后并发症发生风险的可靠指标之一。
[Abstract]:Background and objective postoperative complications are important causes of death after pneumonectomy. In this study, we used the Clavien-Dindo complications classification system to classify the postoperative complications of lung cancer according to the severity, and analyze the incidence of postoperative complications, and explore the risk factors of postoperative complications in different grades. Methods from June 2013 to December 2014, 966 patients with lung cancer who underwent lobectomy in the thoracic surgery department of West China Hospital of Sichuan University were retrospectively analyzed. According to the complications within 30 days after operation, 966 patients were divided into two groups: complication group and non-complication group. According to the Clavien-Dindo classification system, the complications were divided into 4 grades, and the risk factors were analyzed according to the different grades of complications. Results among the 966 patients, 15.0% (145 / 966) of the patients in the complication group had a total incidence of 380 times. According to the Clavien-Dindo classification system, the complications were classified, of which 6.8%, 75.3% were grade I, II, III, IV and above, respectively. 15.0% and 2.9%.Logistic regression analysis showed forced expiratory volume (forded expiratory volume in one second,FEV1) and pulmonary carbon monoxide diffusivity (dif usion capacity for carbon monoxide of the lung single breath,) in the first second before operation. DLco SB) and preoperative chronic obstructive pulmonary disease (chronic obstructive pulmonary disease,COPD) were independent risk factors for postoperative complications. Preoperative FEV1 was an independent risk factor for grade I, II, III and above complications. Conclusion under the Clavien-Dindo grading system, II grade complications are most common within 30 days after operation, and FEV1 is closely related to postoperative complications and can be used as a reliable index to evaluate the risk of postoperative complications.
【作者单位】：四川大学华西医院胸外科;
【分类号】：R734.2

【相似文献】