Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing, 100000, China.
Sci Rep. 2019 Jul 18;9(1):10432. doi: 10.1038/s41598-019-46989-w.
Retrospective studies have found that left upper lobectomy (LUL) may be a new risk factor for stroke, and the potential mechanism is pulmonary vein thrombosis, which more likely develops in the left superior pulmonary vein (LSPV) stump. The LSPV remaining after left pneumonectomy is similar to that remaining after LUL. However, the association between left pneumonectomy, LUL, and postoperative stroke remains unclear. Thus, we sought to analyze whether both LUL and left pneumonectomy are risk factors for postoperative stroke. We prospectively included consecutive patients who underwent resection between November 2016 and March 2018 at our institution with 6 months of follow-up. Baseline demographic and clinical data were taken. A logistic regression model was used to determine independent predictors of postoperative stroke. In our study, 756 patients who underwent an isolated pulmonary lobectomy procedure were screened; of these, 637 patients who completed the 6-month follow-up were included in the analysis. Multivariable logistic regression analysis adjusted for common risk factors showed that the LUL and left pneumonectomy were independent predictors of stroke (odds ratio, 18.12; 95% confidence interval, 2.12-155.24; P = 0.008). Moreover, diabetes mellitus also was a predictor of postoperative stroke. In conclusion, both LUL and left pneumonectomy are significant risk factors for postoperative stroke.
回顾性研究发现，左上肺叶切除术（LUL）可能是中风的新危险因素，潜在机制是肺静脉血栓形成，这更可能发生在左上肺静脉（LSPV）残端。左全肺切除术后残留的 LSPV 与 LUL 后残留的 LSPV 相似。然而，左全肺切除、LUL 和术后中风之间的关联尚不清楚。因此，我们试图分析 LUL 和左全肺切除是否是术后中风的危险因素。我们前瞻性纳入了 2016 年 11 月至 2018 年 3 月在我院接受切除术且随访 6 个月的连续患者。记录基线人口统计学和临床数据。采用逻辑回归模型确定术后中风的独立预测因素。在我们的研究中，筛选了 756 例接受孤立性肺叶切除术的患者；其中，637 例完成 6 个月随访的患者纳入分析。多变量逻辑回归分析调整了常见的危险因素，结果显示 LUL 和左全肺切除是中风的独立预测因素（比值比，18.12；95%置信区间，2.12-155.24；P=0.008）。此外，糖尿病也是术后中风的预测因素。总之，LUL 和左全肺切除都是术后中风的显著危险因素。
