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合并心血管疾病的肺癌切除术患者术后加速康复失败的危险因素:一项单中心回顾性研究。

Risk factors for enhanced recovery after surgery failure in patients undergoing lung cancer resection with concomitant cardiovascular disease: A single-center retrospective study.

作者信息

Sun Lili, Lu Yutong, Zhang Yanfang, Jin Chan, Yuan Zhenwei, Xu Renhua

机构信息

School of Nursing (School of Gerontology), Binzhou Medical University, Yantai, China.

Library, Binzhou Medical University, Yantai, China.

出版信息

Asia Pac J Oncol Nurs. 2024 Jun 7;11(8):100532. doi: 10.1016/j.apjon.2024.100532. eCollection 2024 Aug.

Abstract

OBJECTIVE

Enhanced recovery after surgery (ERAS) has been widely used in patients with lung cancer, and its effectiveness has been confirmed; however, some lung cancers with poor clinical outcomes lead to ERAS failure after radical resection. This study aimed to analyze risk factors associated with ERAS failure after radical resection in patients with lung cancer and concomitant cardiovascular disease.

METHODS

In total, 198 patients who underwent ERAS following radical lung cancer surgery for concomitant cardiovascular disease between January 2022 and September 2023 were enrolled in this retrospective study. The patients were categorized into two groups based on the definition of ERAS failure: ERAS success group ( = 152) and ERAS failure group ( = 46). Univariate and multivariate analyses were performed to investigate the risk factors of ERAS failure.

RESULTS

Univariate analysis showed that gender, tumor location, operation time, estimated blood loss (EBL), suction drainage, and total cholesterol were associated with ERAS failure. Multivariate analysis showed that operation time (odds ratio [OR] = 1.015;  = 0.011) and suction drainage (OR = 3.343;  = 0.008) were independent risk factors for ERAS failure.

CONCLUSIONS

Operation time and suction drainage were independent risk factors for ERAS failure after radical resection of combined cardiovascular lung cancer. Therefore, improving surgical efficiency and postoperative chest drain management are important for successful ERAS.

摘要

目的

术后加速康复(ERAS)已在肺癌患者中广泛应用,其有效性已得到证实;然而,一些临床结局较差的肺癌患者在根治性切除术后导致ERAS失败。本研究旨在分析肺癌合并心血管疾病患者根治性切除术后ERAS失败的相关危险因素。

方法

本回顾性研究纳入了2022年1月至2023年9月期间因合并心血管疾病接受肺癌根治性手术并进行ERAS的198例患者。根据ERAS失败的定义将患者分为两组:ERAS成功组(n = 152)和ERAS失败组(n = 46)。进行单因素和多因素分析以探究ERAS失败的危险因素。

结果

单因素分析显示,性别、肿瘤位置、手术时间、估计失血量(EBL)、胸腔闭式引流和总胆固醇与ERAS失败相关。多因素分析显示,手术时间(比值比[OR]=1.015;P = 0.011)和胸腔闭式引流(OR = 3.343;P = 0.008)是ERAS失败的独立危险因素。

结论

手术时间和胸腔闭式引流是合并心血管疾病的肺癌根治性切除术后ERAS失败的独立危险因素。因此,提高手术效率和术后胸腔引流管理对ERAS的成功至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/21d6/11292427/ef9573fd4bfa/gr1.jpg

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