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术中非甾体类抗炎药对肺切除术后早期肺部并发症的影响:一项回顾性倾向评分匹配研究

Effects of intraoperative non-steroidal anti-inflammatory drugs on early postoperative pulmonary complications following lung resection: a retrospective propensity score-matched study.

作者信息

Zhu Wenzhi, Ma Jing, Wang Xiaoyi, Tan Hongyu

机构信息

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Anesthesiology, Peking University Cancer Hospital & Institute, Beijing, China.

Department of Health Care, Peking Union Medical College Hospital, Beijing, China.

出版信息

J Thorac Dis. 2025 May 30;17(5):3004-3014. doi: 10.21037/jtd-2024-2007. Epub 2025 May 28.

DOI:10.21037/jtd-2024-2007
PMID:40529757
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12170004/
Abstract

BACKGROUND

Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used in surgery. The retrospective study was performed to explore the efficacy of intraoperative NSAIDs on postoperative pulmonary complications (PPCs) in patients with non-small cell lung cancer (NSCLC) after surgery.

METHODS

Patients with NSCLC who underwent lung resection between January 1 and May 31, 2019, were included in this study. Patients who were given NSAIDs were assigned to the NSAIDs group, while patients who did not receive NSAIDs were assigned to the control group. Propensity score matching (PSM) was performed to reduce confounding bias. The primary endpoint was PPCs.

RESULTS

In the study, 139 patients received perioperative NSAIDs, while 167 patients did not. Propensity score-matched analysis created a matched cohort of 238 patients, with 119 patients in each group. After matching, the frequencies of postoperative pneumonia, respiratory failure, and myocardial ischemia were significantly lower in the NSAIDs group than those in the control group (P<0.05). Compared to the control group, there were reduced intraoperative fentanyl equivalents, lower intensive care unit (ICU) admission rate and shorter postoperative hospital stay (PHS) in the NSAIDs group (P<0.05).

CONCLUSIONS

The use of intraoperative NSAIDs decreased the incidence of postoperative pneumonia and respiratory failure, lowered ICU admission rate and shortened the PHS.

摘要

背景

非甾体类抗炎药(NSAIDs)在手术中广泛使用。本回顾性研究旨在探讨术中使用NSAIDs对非小细胞肺癌(NSCLC)患者术后肺部并发症(PPCs)的疗效。

方法

纳入2019年1月1日至5月31日期间接受肺切除术的NSCLC患者。给予NSAIDs的患者被分配到NSAIDs组,未接受NSAIDs的患者被分配到对照组。进行倾向评分匹配(PSM)以减少混杂偏倚。主要终点是PPCs。

结果

在本研究中,139例患者接受了围手术期NSAIDs治疗,而167例患者未接受。倾向评分匹配分析产生了一个由238例患者组成的匹配队列,每组119例。匹配后,NSAIDs组术后肺炎、呼吸衰竭和心肌缺血的发生率显著低于对照组(P<0.05)。与对照组相比,NSAIDs组术中芬太尼当量减少,重症监护病房(ICU)入住率降低,术后住院时间(PHS)缩短(P<0.05)。

结论

术中使用NSAIDs可降低术后肺炎和呼吸衰竭的发生率,降低ICU入住率并缩短PHS。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d24/12170004/1424b3cce9a9/jtd-17-05-3004-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d24/12170004/1424b3cce9a9/jtd-17-05-3004-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d24/12170004/1424b3cce9a9/jtd-17-05-3004-f1.jpg

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J Clin Med. 2024 Aug 27;13(17):5083. doi: 10.3390/jcm13175083.
2
Anesthetic predictors for postoperative pneumonia in patients with non-small cell lung cancer.非小细胞肺癌患者术后肺炎的麻醉预测因素
J Thorac Dis. 2024 May 31;16(5):3204-3212. doi: 10.21037/jtd-24-107. Epub 2024 May 29.
3
Postoperative Complications Associated with Non-Steroidal Anti-Inflammatory Combinations Used Status-Post Total Hip and Knee Arthroplasty.
全髋关节和全膝关节置换术后使用非甾体类抗炎药联合用药的术后并发症
J Clin Med. 2023 Nov 7;12(22):6969. doi: 10.3390/jcm12226969.
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Non-Invasive Ventilation Reduces Postoperative Respiratory Failure in Patients Undergoing Bariatric Surgery: A Retrospective Analysis.减重手术后使用无创通气可降低术后呼吸衰竭发生率:一项回顾性分析。
Medicina (Kaunas). 2023 Aug 12;59(8):1457. doi: 10.3390/medicina59081457.
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Risk stratification of postoperative pulmonary complications in elderly patients undergoing lung cancer resection: a propensity score-matched study.老年肺癌切除患者术后肺部并发症的风险分层:一项倾向评分匹配研究。
J Thorac Dis. 2023 Jul 31;15(7):3908-3918. doi: 10.21037/jtd-23-923. Epub 2023 Jul 25.
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Effects of Opioids on Immune and Endocrine Function in Patients with Cancer Pain.阿片类药物对癌症疼痛患者免疫和内分泌功能的影响。
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