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与原发性肺癌肺切除术后围手术期并发症相关的因素。

Factors associated with perioperative complications after pneumonectomy for primary carcinoma of the lung.

作者信息

Dancewicz Maciej, Kowalewski Janusz, Peplinski Janusz

机构信息

Department of Thoracic Surgery and Tumors, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, Centrum Onkologii, Ul. I. Romanowskiej 2, 85-796 Bydgoszcz, Poland.

出版信息

Interact Cardiovasc Thorac Surg. 2006 Apr;5(2):97-100. doi: 10.1510/icvts.2005.118125. Epub 2005 Dec 23.

Abstract

According to the literature patient's age, nutrition and smoking status, cardiopulmonary comorbidity and surgeon's experience are the main factors associated with perioperative complications after pulmonary resection. The purpose of the study was to identify the correlation between pre- and intraoperative risk factors and complications after pneumonectomy for primary carcinoma of the lung. Between Sept. 11th 1999 and Dec. 20th 2003 121 standard pneumonectomies were performed in patients with non small-cell lung cancer. Sixteen risk factors noted in the patients before surgery were correlated with complications occurred after pneumonectomy. Overall mortality and morbidity rates were 3.3% and 30.6%, respectively. Twenty patients (16.5%) experienced cardiac rhythm disturbances, six (4.9%)--pleural haematomas, five (4.1%)--main bronchus stump fistulas, four (3.3%)--acute respiratory failure. Chronic obstructive pulmonary disease was correlated with broncho-pleural fistulas and acute respiratory failure after surgery. Chronic coronary disease was associated with postoperative cardiac arrhythmias, whereas postoperative bleeding was correlated with the overweight of the patients. Chronic obstructive pulmonary disease, chronic coronary disease and overweight are the risk factors associated with complications after pneumonectomy.

摘要

根据文献,患者的年龄、营养状况和吸烟状态、心肺合并症以及外科医生的经验是肺切除术后围手术期并发症的主要相关因素。本研究的目的是确定原发性肺癌肺切除术前和术中危险因素与并发症之间的相关性。1999年9月11日至2003年12月20日期间,对121例非小细胞肺癌患者进行了标准肺切除术。术前记录的16项危险因素与肺切除术后发生的并发症相关。总体死亡率和发病率分别为3.3%和30.6%。20例患者(16.5%)出现心律失常,6例(4.9%)出现胸膜血肿,5例(4.1%)出现主支气管残端瘘,4例(3.3%)出现急性呼吸衰竭。慢性阻塞性肺疾病与术后支气管胸膜瘘和急性呼吸衰竭相关。慢性冠状动脉疾病与术后心律失常相关,而术后出血与患者超重相关。慢性阻塞性肺疾病、慢性冠状动脉疾病和超重是肺切除术后并发症的危险因素。

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