使用国际体力活动问卷预测全麻下胸腔镜肺手术后不同体力活动水平与术后肺部并发症的关系：一项前瞻性队列研究方案。

Predicting the association of different levels of physical activity on postoperative pulmonary complications using the international physical activity questionnaire in patients undergoing thoracoscopic lung surgery under general anaesthesia: protocol for a prospective cohort study.

机构信息

Weifang Medical University, Weifang, Shandong, China.

Shandong University, Jinan, Shandong, China.

出版信息

BMJ Open. 2024 May 15;14(5):e077183. doi: 10.1136/bmjopen-2023-077183.

DOI:10.1136/bmjopen-2023-077183

PMID:38749692

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11097810/

Abstract

INTRODUCTION

Postoperative pulmonary complications (PPCs) occur frequently in patients undergoing lung surgery under general anaesthesia and are strongly associated with longer postoperative hospital stays and increased mortality. The existing literature has shown that a higher level of preoperative physical activity (PA) plays a positive role in the low incidence of postoperative complications and the quality of life in patients undergoing lung surgery. However, the association between preoperative PA levels and the incidence of PPCs has rarely been studied, particularly in thoracoscopic lung surgery. This study aims to evaluate PA levels in patients undergoing thoracoscopic lung surgery using the International Physical Activity Questionnaire and to investigate the association between PA levels and the incidence of PPCs.

METHODS AND ANALYSIS

A total of 204 participants aged 18-80 years undergoing thoracoscopic lung surgery (thoracoscopic wedge resection, thoracoscopic segmentectomy and thoracoscopic lobectomy) will be included in the study. The primary outcome is the incidence of PPCs within the first 5 postoperative days. The secondary outcomes include the number of PPCs, the incidence of PPCs 1 month postoperatively, the arterial blood levels of inflammatory markers, the incidence of postoperative adverse events within the first 5 postoperative days, extubation time, unplanned admission to the intensive care unit, postoperative length of stay and mortality 1 month postoperatively.

ETHICS AND DISSEMINATION

The study was reviewed and approved by the Research Ethics Committee of the First Affiliated Hospital of Shandong First Medical University on 31 March 2022 (YXLL-KY-2022(014)) and is registered at ClinicalTrials.gov. We plan to disseminate the data and findings of this study in international and peer-reviewed journals.

TRIAL REGISTRATION NUMBER

The trial has been prospectively registered at the clinicaltrials.gov registry (NCT05401253).

摘要

简介

全身麻醉下接受肺手术的患者常发生术后肺部并发症（PPC），且 PPC 与术后住院时间延长和死亡率增加密切相关。现有文献表明，术前较高水平的体力活动（PA）对降低肺手术后并发症发生率和提高患者生活质量具有积极作用。然而，术前 PA 水平与 PPC 发生率之间的关联很少被研究，尤其是在胸腔镜肺手术中。本研究旨在使用国际体力活动问卷（International Physical Activity Questionnaire）评估接受胸腔镜肺手术患者的 PA 水平，并探讨 PA 水平与 PPC 发生率之间的关系。

方法和分析

本研究共纳入 204 名年龄在 18-80 岁之间、接受胸腔镜肺手术（胸腔镜楔形切除术、胸腔镜节段切除术和胸腔镜肺叶切除术）的患者。主要结局是术后 5 天内 PPC 的发生率。次要结局包括 PPC 数量、术后 1 个月 PPC 发生率、炎症标志物的动脉血水平、术后 5 天内不良事件发生率、拔管时间、非计划转入重症监护病房、术后住院时间和术后 1 个月死亡率。