肺部手术后二次胸腔切除血静的相关因素:一个回顾性分析
Junwei Xie1,2,3, Hongliang Wang4, Tianci Han1
1Department of Thoracic Surgery, Liaoning Cancer Hospital & Institute, Shenyang, China.
Frontiers in oncology
|September 3, 2025
概括
肺癌手术后的二次胸腔切除是罕见的, 但与肺部粘附和吸烟有关. 改善的手术技术,如胸腔镜,正在减少它的发生.
科学领域:
- 胸部手术
- 外科瘤学
- 肺部医学
背景情况:
- 肺癌手术后的二次胸腔切除是罕见但严重的并发症.
- 这种手术可能会导致住院时间延长,医疗费用增加,患者发病率增加.
- 现有的文献缺乏全面的分析,仅限于案例报告或基于经验的摘要.
研究的目的:
- 系统地调查肺癌手术后二次胸腔切除的原因和治疗方法.
- 确定与二次胸切除术需要相关的关键风险因素.
- 分析二次胸切除术发生率的趋势和影响这些趋势的因素.
主要方法:
- 在2015年1月至2022年12月期间接受二次胸腔切除治疗的39名患者的回顾性分析.
- 收集的数据包括手术方法,瘤分期,出血部位和静血技术.
- 用物流回归分析来确定二次胸切除术的危险因素.
主要成果:
- 二次胸切除术的发生率为0. 257% (在15156例肺部手术中,有39例).
- 显著的风险因素包括肺部粘附 (aOR=20. 00),吸烟史 (aOR=3. 56) 和男性性别 (aOR=3. 21).
- 常见的出血发生在粘附释放部位和肺膜损伤;随着胸腔镜手术的增加,发病率下降.
结论:
- 胸腔粘附和吸烟史是二次胸切除术的重要危险因素.
- 细致的血液静止,特别是在粘附部位和肺损伤部位,至关重要.
- 胸腔镜手术的进步有助于减少二次胸切除术的发生率,因此需要进一步研究其他可能导致的因素.
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