在接受肺癌切除的老年患者中,术后肺部并发症的风险分层:一种倾向性得分匹配的研究
Qiubo Huang1, Ritika Rauniyar1, Jiao Yang2
1Department of Thoracic Surgery, The Third Affiliated Hospital of Kunming Medical University, Kunming, China.
Journal of thoracic disease
|August 10, 2023
概括
接受手术的老年肺癌患者面临肺部并发症的风险. 美国麻醉学会 (ASA) 课程和视频辅助胸腔镜手术 (VATS) 显著降低了这些风险.
科学领域:
- 胸部外科手术 胸部外科手术
- 老年瘤学 老年瘤学
- 肺部医学 肺部医学
背景情况:
- 肺癌不成比例地影响中国的老年人.
- 手术后肺部并发症 (PPC) 是老年人肺切除后发病和死亡的重要原因.
- 识别PPC的预测因素对于改善患者的治疗结果至关重要.
研究的目的:
- 在为肺癌进行肺切除的老年患者中确定PPC的外科预测因子.
- 提供证据,以加强预防和干预策略,在这个人群中治疗PPC.
主要方法:
- 对456名老年患者 (65岁以上) 进行了回顾性研究,这些患者因肺癌而接受肺切除.
- 倾向性得分匹配 (PSM) 和二进制后勤回归被用于分析术前数据和临床特征.
- 从2016年1月到2019年3月在中国云南省收集的数据.
主要成果:
- 31.1%的老年患者经历了PPC,肺炎是最常见的 (21.7%).
- 美国麻醉学会 (ASA) 下级 (II) 是对PPCs的保护因素 (OR:0.177,95%CI:0.037-0.854).
- 视频辅助胸腔镜手术 (VATS) 也被确定为一种保护因素 (OR:0.576,95%CI:0.334-0.992).
结论:
- 更高的ASA分类和开放胸切除术与老年肺癌患者的PPCs增加有关.
- 建议对ASA类>II或接受开放胸腔切除术的老年患者进行全面的外科战略评估和增强的恢复方案.
- 积极的管理策略可以帮助减轻PPCs在这个脆弱的患者群体.
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