大型瘤手术后术后肺部并发症和相关风险因素的发生率:前性观察性研究
Shilpi Agarwal1, Rakesh Garg, Sushma Bhatnagar
1Department of Onco-Anaesthesia and Palliative Medicine, Dr BRAIRCH, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
Indian journal of cancer
|February 17, 2025
概括
手术后肺部并发症 (PPC) 影响 28.05% 接受重大癌症手术的患者. 关键的风险因素包括异常的BMI,吸烟和低白蛋白水平,突出了针对性干预的必要性.
科学领域:
- 在瘤学瘤学.
- 肺部病理学 肺部病理学
- 手术重症监护手术重症监护
背景情况:
- 手术后的肺部并发症 (PPC) 是手术后发病的一个重要原因.
- 瘤手术是复杂的,并且由于其持续时间和广泛的组织操纵,与PPCs的高风险有关.
- 不同类型的PPC定义使准确的发病率评估和风险分层变得复杂.
研究的目的:
- 确定在接受重大瘤手术的患者中PPC的发生率.
- 确定与该患者群体中PPC发展相关的独立风险因素.
- 评估ARISCAT评分对瘤外科手术患者PPC的预测价值.
主要方法:
- 一项前性观察性研究,涉及接受重大瘤手术的患者.
- 收集人口统计,手术前和手术内数据.
- 在手术后对PPC进行监测,直到出院,使用ARISCAT评分进行风险评估.
- 多变量回归和千平方趋势分析用于风险因素识别和PPC趋势分析.
主要成果:
- PPCs的总发病率为28.05%,呼吸系统衰竭和透症是最常见的.
- 胸切除术 (41.6%) 和细胞减小手术 (40.6%) 显示PPC发生率最高.
- 确定的危险因素包括BMI极端 (<18.5或>25公斤/米2),吸烟,鼻胃管使用,年龄>60岁和低白蛋白 (<3.5克/分升).
结论:
- 在接受重大瘤手术的患者中,PPC发生在28.05%的患者中.
- 瘤外科手术中PPC的独立风险因素包括异常的BMI,吸烟,鼻胃管使用,年龄较大和低albuminemia.
- 阿里斯卡得分有效地分层风险,较低的得分与较低的PPC发病率相关.
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