老年肺癌患者胸腔镜肺切除术后并发心律失常的临床特征及危险因素分析

doi:10.3969/j.issn.1006-7795.2022.04.009

首都医科大学学报 ›› 2022, Vol. 43 ›› Issue (4): 564-569.doi: 10.3969/j.issn.1006-7795.2022.04.009

• 肺癌一体化诊断和治疗 • 上一篇下一篇

老年肺癌患者胸腔镜肺切除术后并发心律失常的临床特征及危险因素分析

张静涛, 王欣然, 韩斌如, 强莹, 刘雪琪, 张毅^*

首都医科大学宣武医院胸外科,北京 100053

收稿日期:2022-04-13 出版日期:2022-08-21 发布日期:2022-10-28
基金资助:
首都医学发展科研基金(2022-2-2013)。

Analysis of clinical characteristics and risk factors of arrhythmia after thoracoscopic pneumonectomy in elderly patients with lung cancer

Zhang Jingtao, Wang Xinran, Han Binru, Qiang Ying, Liu Xueqi, Zhang Yi^*

Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China

Received:2022-04-13 Online:2022-08-21 Published:2022-10-28
Contact: *E-mail:zhangyi@xwhosp.org
Supported by:
This study was supported by Capital Medical Development Research Fund (2022-2-2013).

摘要/Abstract

摘要： 目的探讨≥60岁的老年肺癌患者行全身麻醉(以下简称全麻)下胸腔镜肺切除手术后并发心律失常的危险因素。方法回顾性分析2021年10月至2021年12月于首都医科大学宣武医院胸外科病房住院手术的100例老年肺癌患者的资料,将其中诊断为并发心律失常的19例患者作为观察组 (心律失常组),诊断为非心律失常的81例患者作为对照组(非心律失常组)。采用单因素和多因素 Logistic 回归分析危险因素。结果老年肺癌患者胸腔镜肺癌切除术后在住院期间心律失常的总发生率为19%。其中年龄、高血压、术后便秘、手术方式、血清白蛋白浓度是患者肺癌术后发生心律失常的独立的影响因素。结论对于老年肺癌患者可通过年龄、高血压、术后便秘、手术方式、血清白蛋白浓度异常等几项指标来推断发生术后心律失常的可能性,进而有针对性地给予治疗,以达到尽早诊断及预防术后并发心律失常的效果。

关键词: 老年, 胸腔镜, 肺癌切除术, 心律失常, 临床特征, 危险因素

Abstract: Objective To investigate the risk factors of arrhythmia in elderly lung cancer patients age≥60 years after thoracoscopic pneumonectomy under general anesthesia. Methods Retrospective analysis was performed on the data of 100 elderly lung cancer patients admitted to Xuanwu Hospital, Capital Medical University from October 2021 to December 2021. Patients diagnosed with concurrent arrhythmia were selected as the observation group (arrhythmia group), and patients diagnosed with non-arrhythmia were selected as the control group (non-arrhythmia group). Univariate and multivariate Logistic regression were used to analyze risk factors. Results The total incidence of arrhythmia in hospitalized patients after thoracoscopic lung cancer resection was 19%. Age, surgical methods, complications and hypertension were independent risk factors for arrhythmia in patients with lung cancer surgery. Conclusion For elderly lung cancer patients, the possibility of postoperative arrhythmia could be inferred by the age, past history of hypertension, postoperative constipation, surgical methods, albumin abnormalities, and then targeted treatment, in order to achieve early diagnosis and prevention of postoperative arrhythmia.

Key words: elderly, thoracoscopy, lung cancer resection, arrhythmia, clinical features, risk factors

中图分类号:

R734.2

张静涛, 王欣然, 韩斌如, 强莹, 刘雪琪, 张毅. 老年肺癌患者胸腔镜肺切除术后并发心律失常的临床特征及危险因素分析[J]. 首都医科大学学报, 2022, 43(4): 564-569.

Zhang Jingtao, Wang Xinran, Han Binru, Qiang Ying, Liu Xueqi, Zhang Yi. Analysis of clinical characteristics and risk factors of arrhythmia after thoracoscopic pneumonectomy in elderly patients with lung cancer[J]. Journal of Capital Medical University, 2022, 43(4): 564-569.

参考文献

[1] 张化芝, 郭晓烨, 李晓双, 等. 肺癌术后并发肺部感染的病原学分析及影响因素分析[J]. 中华医院感染学杂志, 2018, 28(1):77－80.
[2] Forde P M, Chaft J E, Smith K N, et al. Neoadjuvant PD－1 blockade in resectable lung cancer[J]. N Engl J Med, 2018, 378(21):1976－1986.
[3] Rolfo C, Mack P C, Scagliotti G V, et al. Liquid biopsy for advanced Non-small cell lung cancer (NSCLC):a statement paper from the IASLC[J]. J Thorac Oncol, 2018, 13(9):1248－1268.
[4] Gonlugur T E, Gonlugur U. Comorbidity as a prognostic factor in small cell lung cancer[J]. Tumori, 2006, 92(5):423－428.
[5] 吕玲, 姜成钢, 兰心刚, 等. 肺癌术后心律失常的相关危险因素分析[J]. 中国医科大学学报, 2012, 41(3):258－261.
[6] 赵嘉华, 初向阳, 薛志强, 等. 352例高龄肺癌术后心律失常的危险因素分析[J]. 中国肺癌杂志, 2011, 14(3):251－255.
[7] 高凤敏, 曹颖平. 诊断学[M]. 北京: 中国医药科技出版社, 2016.
[8] 中华人民共和国国家卫生健康委员会. 癌症疼痛诊疗规范(2018年版)[J]. 临床肿瘤学杂志, 2018, 23(10):937－944.
[9] 张丹, 夏志伟. 功能性便秘的罗马Ⅲ标准[J]. 中国医刊, 2008, 43(12):63－64.
[10] 肖懿慧, 高渊, 吴燕, 等. 肺癌术后房性心律失常的多因素分析[J]. 现代肿瘤医学, 2019, 27(16):2864－2867.
[11] Parayath N N, Parikh A, Amiji M M. Repolarization of Tumor-Associated macrophages in a genetically engineered nonsmall cell lung cancer model by intraperitoneal administration of hyaluronic acid-based nanoparticles encapsulating MicroRNA－125b[J]. Nano Lett, 2018, 18(6):3571－3579.
[12] Thakur M K, Ruterbusch J J, Schwartz A G, et al. Risk of second lung cancer in patients with previously treated lung cancer: analysis of surveillance, epidemiology, and end results (SEER) data[J]. J Thorac Oncol, 2018, 13(1):46－53.
[13] Nomura S, Yokoi T, Kurata T. Platelet-related indices in patients with lung cancer with nivolumab[J]. Platelets, 2018, 29(2):207－208.
[14] Jemal A, Miller K D, Ma J M, et al. Higher lung cancer incidence in young women than young men in the United States[J]. N Engl J Med, 2018, 378(21):1999－2009.
[15] Wu D H, Xu M Y, Mao T, et al. Risk factors for intraoperative atrial fibrillation: a retrospective analysis of 10,563 lung operations in a single center[J]. Ann Thorac Surg, 2012, 94(1):193－197.
[16] 许建宁, 刘国锋. 全胸腔镜术式与开胸肺叶切除术对早期NSCLC患者围手术期的影响[J]. 实用肿瘤杂志, 2017, 32(6):511－514.
[17] Schiller J H. A new standard of care for advanced lung cancer[J]. N Engl J Med, 2018, 378(22):2135－2137.
[18] Vrankar M, Zwitter M, Kern I, et al. PD-L1 expression can be regarded as prognostic factor for survival of non-small cell lung cancer patients after chemoradiotherapy[J]. Neoplasma, 2018, 65(1):140－146.
[19] 郑中龙, 李涛, 卿松. 全程管理体系在肺癌患者术后便秘的预防及治疗中的应用[J]. 黑龙江医学, 2020, 44(8):1013－1015.
[20] Brown T J, Keshvani N, Gupta A, et al. Rates of appropriate laxative prophylaxis for opioid-induced constipation in veterans with lung cancer: a retrospective cohort study[J]. Support Care Cancer, 2020, 28(11):5315－5321.
[21] 何浩, 沙永生, 孔轻轻. 肺癌患者全肺切除术后并发心律失常的原因分析及护理对策[J]. 护士进修杂志, 2013, 28(11):1011－1014.

老年肺癌患者胸腔镜肺切除术后并发心律失常的临床特征及危险因素分析

Analysis of clinical characteristics and risk factors of arrhythmia after thoracoscopic pneumonectomy in elderly patients with lung cancer

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