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接受手术干预的胸内包虫囊肿病患者住院时间的相关因素:一项回顾性研究

Factors associated with hospital length of stay in patients with thoracic hydatid cyst disease undergoing surgical intervention: a retrospective study.

作者信息

Ershadi Reza, Salehi Mohammadreza, Roostaei Ghazal, Rad Niloofar Khoshnam, Soltanmohammadi Sara, Amini Hesam

机构信息

Department of Thoracic Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.

Research Center for Antibiotic Stewardship and Antimicrobial Resistance, Imam Khomeini Hospital Complex, Department of Infectious Diseases, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

J Cardiothorac Surg. 2025 Jan 7;20(1):39. doi: 10.1186/s13019-024-03291-9.

Abstract

BACKGROUND

Hydatid cyst (HC) frequently affects the lungs, making it the second most common site after the liver. This study evaluated the clinical characteristics, surgical procedures, complications, laboratory findings, and factors influencing hospital length of stay (LOS) in patients undergoing surgery for pulmonary hydatid cysts.

METHODS

This retrospective observational study included adult patients who underwent surgery for lung HC between 2017 and 2021. Data were collected using a standardized checklist covering demographics, medical history, clinical symptoms, laboratory findings, treatment details, surgical characteristics, and risk factors. The primary outcome was LOS, defined as the duration between surgery and discharge.

RESULTS

A retrospective analysis of 214 patients with pulmonary hydatid cysts revealed a male predominance (59.3%; median age, 36 years). The most common symptom was cough (39.3%), followed by chest pain and dyspnea. Right lower lobe involvement (51.4%) and synchronous liver cysts (13.6%) were frequently observed. Elevated erythrocyte sedimentation rate (ESR), eosinophilia, positive serology, prolonged air leak, and fever were correlated with longer LOS. The dominant surgical procedure was cystotomy with capitonnage (95.8%), performed via thoracotomy.

CONCLUSIONS

Most hydatid cysts were located in the right lower lobe, with cough being the most frequent presenting symptom. Thoracotomy and cystotomy with capitonnage were the primary surgical procedures performed. Common postoperative complications included wound infection, empyema, and prolonged air leak. Awareness of factors such as elevated ESR, eosinophilia, positive serology, prolonged air leak, and fever may improve management and reduce hospital LOS.

摘要

背景

包虫囊肿(HC)常累及肺部,使其成为仅次于肝脏的第二常见部位。本研究评估了接受肺包虫囊肿手术患者的临床特征、手术方式、并发症、实验室检查结果以及影响住院时间(LOS)的因素。

方法

这项回顾性观察研究纳入了2017年至2021年间接受肺HC手术的成年患者。使用标准化检查表收集数据,涵盖人口统计学、病史、临床症状、实验室检查结果、治疗细节、手术特征和危险因素。主要结局是住院时间,定义为手术至出院的时长。

结果

对214例肺包虫囊肿患者的回顾性分析显示男性居多(59.3%;中位年龄36岁)。最常见症状是咳嗽(39.3%),其次是胸痛和呼吸困难。右肺下叶受累(51.4%)和同时存在肝囊肿(13.6%)较为常见。红细胞沉降率(ESR)升高、嗜酸性粒细胞增多、血清学阳性、漏气时间延长和发热与住院时间延长相关。主要手术方式是带帽外翻缝合的囊肿切开术(95.8%),通过开胸手术进行。

结论

大多数包虫囊肿位于右肺下叶,咳嗽是最常见的症状。开胸手术和带帽外翻缝合的囊肿切开术是主要实施的手术方式。常见术后并发症包括伤口感染、脓胸和漏气时间延长。认识到ESR升高、嗜酸性粒细胞增多、血清学阳性、漏气时间延长和发热等因素可能有助于改善管理并缩短住院时间。

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