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与阻塞性肺炎相关的肺癌的手术结果

Surgical results of lung cancer associated with postobstructive pneumonia.

作者信息

Haraguchi Shuji, Koizumi Kiyoshi, Tanimura Shigeo, Hirata Tomomi, Hirai Kyoji, Mikami Iwao, Kubokura Hirotoshi, Shimizu Kazuo

机构信息

Division of Thoracic Surgery, Department of Surgery, Nippon Medical School, Japan.

出版信息

Ann Thorac Cardiovasc Surg. 2009 Oct;15(5):297-303.

Abstract

PURPOSE

We report surgical results of lung cancer associated with postobstructive pneumonia.

MATERIALS AND METHODS

We report on morbidity and mortality, and we analyze the risk factors for them and the prognostic factors for overall survival of patients without mortality.

RESULTS

Morbidity developed in 13 of the 38 patients (34.2%). Mortality rate was 10.5%. Hemoglobin concentration before surgery and predicted postoperative forced expiratory volume in one second were significantly low in patients with morbidity and mortality based on the univariate analyses. Predicted postoperative forced expiratory volume in one second was a significant risk factor for morbidity based on a multivariate analysis. Poor prognostic factors for overall survival were serum albumin concentration, hemoglobin concentration, and performance status before surgery, combined resection, and pathological stage. Serum albumin concentration was significant based on a multivariate analysis.

CONCLUSIONS

Morbidity and mortality are high in patients with lung cancer associated with postobstructive pneumonia. Morbidity demonstrates significant association with low predicted postoperative forced expiratory volume in one second and hemoglobin concentration, indicating the need for preoperative transfusion in severe anemia or bronchoplasty if possible. Poor nutritional state before surgery possibly derived from cachexia may influence not only morbidity and mortality, but also prognosis.

摘要

目的

我们报告与阻塞性肺炎相关的肺癌手术结果。

材料与方法

我们报告发病率和死亡率,并分析其危险因素以及无死亡患者的总生存预后因素。

结果

38例患者中有13例(34.2%)发生并发症。死亡率为10.5%。单因素分析显示,发生并发症和死亡的患者术前血红蛋白浓度及预计术后第一秒用力呼气量显著降低。多因素分析显示,预计术后第一秒用力呼气量是并发症的显著危险因素。总生存的不良预后因素为术前血清白蛋白浓度、血红蛋白浓度、体能状态、联合切除及病理分期。多因素分析显示血清白蛋白浓度具有显著性。

结论

与阻塞性肺炎相关的肺癌患者并发症发生率和死亡率较高。并发症与预计术后第一秒用力呼气量降低及血红蛋白浓度显著相关,提示严重贫血时可能需要术前输血,或尽可能行支气管成形术。术前可能因恶病质导致的营养状态差不仅影响并发症发生率和死亡率,还影响预后。

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