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肺切除术后持续性咳嗽的特征和危险因素。

Characteristics and Risk Factors for Persistent Cough After Pulmonary Resection.

机构信息

Department of Thoracic Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Department of Thoracic Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

出版信息

Ann Thorac Surg. 2023 Jun;115(6):1337-1343. doi: 10.1016/j.athoracsur.2022.05.054. Epub 2022 Jun 29.

Abstract

BACKGROUND

Persistent cough after pulmonary resection may reduce quality of life for patients. However, there remains a lack of description of clinical characteristics and the risk factors for persistent cough after pulmonary resection. This study aimed to describe the characteristics of persistent cough after pulmonary resection and investigate independent risk factors for it.

METHODS

This single-institution study retrospectively included 901 consecutive patients who had undergone thoracoscopic pulmonary resection between June 2019 and December 2020. The characteristics of persistent cough after pulmonary resection are described, and univariable and multivariable regression analyses were performed to identify the independent risk factors for persistent cough after pulmonary resection.

RESULTS

Persistent cough after pulmonary resection occurred in 190 (21.1%) of the patients. It was usually an irritating dry cough (75.3%) that appeared on postoperative day 7 (interquartile range [IQR], 6-9) and lasted for approximately 5 (IQR, 2-6) months. It was often induced by a pungent smell, cold air, deep inhalation, speaking, postural changes, pungent food, or emotional excitement. Multivariable analyses showed that resection of the right upper lobe (odds ratio [OR] 2.311, 95% CI 1.246-4.285) and mediastinal lymph node removal (OR 3.686, 95% CI 2.140-6.346) were independently associated with the risk of persistent cough after pulmonary resection.

CONCLUSIONS

Persistent cough after pulmonary resection is a common complication that should receive more attention. Mediastinal lymph node removal and resection of the right upper lobe may be independent risk factors for persistent cough after pulmonary resection.

摘要

背景

肺切除术后持续性咳嗽可能会降低患者的生活质量。然而,目前仍缺乏对肺切除术后持续性咳嗽的临床特征和危险因素的描述。本研究旨在描述肺切除术后持续性咳嗽的特征,并探讨其独立的危险因素。

方法

这是一项单中心回顾性研究,纳入了 2019 年 6 月至 2020 年 12 月期间接受胸腔镜肺切除术的 901 例连续患者。描述了肺切除术后持续性咳嗽的特征,并进行了单变量和多变量回归分析,以确定肺切除术后持续性咳嗽的独立危险因素。

结果

肺切除术后持续性咳嗽发生在 190 例(21.1%)患者中。通常是一种刺激性干咳(75.3%),出现在术后第 7 天(四分位距[IQR],6-9),持续约 5 个月(IQR,2-6)。它通常由刺激性气味、冷空气、深呼吸、说话、体位改变、刺激性食物或情绪激动引起。多变量分析显示,右上叶切除(优势比[OR] 2.311,95%可信区间[CI] 1.246-4.285)和纵隔淋巴结清扫(OR 3.686,95%CI 2.140-6.346)是肺切除术后持续性咳嗽的独立危险因素。

结论

肺切除术后持续性咳嗽是一种常见的并发症,应引起更多的关注。纵隔淋巴结清扫和右上叶切除可能是肺切除术后持续性咳嗽的独立危险因素。

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