肺癌根治术后并发急性呼吸窘迫综合征的危险因素分析及治疗
Risk factors for acute respiratory distress syndrome after radical lung cancer resection analysis and treatment
程国升 1魏芳芳 1卢世军 1韩洁 1邢攸学1
作者信息
- 1. 临沂市中心医院重症医学科,山东临沂 276400
- 折叠
摘要
目的 对于肺癌手术后出现急性呼吸窘迫综合征(ARDS)的风险因子进行研究并提出相应的医疗策略.方法 回顾性分析2020年4月～2023年4月在临沂市中心医院接受根治术治疗的315例肺癌患者资料,依照ARDS的出现状态进行分类,然后通过比较和筛查不同的变量,最终运用多元Logistic线性回归分析手术后ARDS的风险因子.结果 315例肺癌患者术后并发ARDS者28例,未发生ARDS者287例,ARDS发生率为8.89％;单因素分析显示,ARDS组性别、年龄、体重指数、肿瘤分期、术式、吸烟史、术中出血量、胶体输液量与非ARDS组比较(P＞0.05);两组手术耗时、FEV1％的预估数据、接受过的化学治疗的历程、注射晶体量、单肺的呼吸持续时间、单肺气道压进行对比(P＜0.05);多因素分析显示,手术耗时、FEV1％的预估数据、接受放化疗的历程、注射晶体量、单肺的呼吸持续时间、单肺气道压是肺癌根治术后并发ARDS的危险因素.结论 肺癌根治术后并发ARDS危险因素较多,术前需采取针对性预防措施,对于发生ARDS患者应及时开展机械通气、液体管理等综合治疗.
Abstract
Objective To study the risk factors for acute respiratory distress syndrome(ARDS)after lung cancer surgery and to propose corresponding medical strategies.Methods The data of 315 lung cancer patients who underwent radical resection in Linyi Central Hospital from April 2020～April 2023 were retrospectively analyzed,classified according to the occurrence status of ARDS,and then compared and screened different variables,and finally the risk factors of ARDS after surgery were analyzed by multivariate Logistic linear regression.Results Among the 315 lung cancer patients,28 patients had ARDS after surgery and 287 patients did not develop ARDS,with an incidence rate of 8.89＞％.Multivariate analysis showed that the duration of sur-gery,estimated FEV1％,duration of radiotherapy,amount of injected crystals,duration of breathing in one lung,and airway pressure in one lung were risk factors for ARDS after radical resection of lung cancer.Conclusions There are many risk factors for ARDS after radical resec-tion of lung cancer,and targeted preventive measures should be taken before surgery,and com-prehensive treatment such as mechanical ventilation and fluid management should be carried out in time for patients with ARDS.
关键词
肺癌/手术/急性呼吸窘迫综合征/危险因素Key words
lung cancer/surgery/acute respiratory distress syndrome/risk factors引用本文复制引用
出版年
2024
NETL
NSTL
万方数据