Objective To investigate the effect of weakness on perioperative complications of thyroid, breast and hernia surgery in general surgery. Methods Patients receiving thyroid breast surgery in Liaoning Provincial People′s Hospital were randomly selected from May 2014 to May 2017. The demographic variables of each patient were recorded, and the demographic variables were stratified. Each group of people was scored with a weakness index (mFI), with complications and serious complications as the dependent variables, and the demographic variables and mFI scores were used as covariates. Cox proportional hazard regression analysis of covariates and dependent variables was performed, the covariates were stratified, and risk factors between subgroups were compared. Results A total of 1 408 patients were eligible for inclusion in the above inclusion criteria. The female population was 801, with an average age of (59.7 ± 11.6) years, an average body mass index (BMI) of (28.7 ± 7.4) kg/m2. Compared with those in low mFI, the risk of complications and serious complications increased significantly (P <0.01) in moderate mFI ( HR=1.60, HR=2.10), and high mFI ( HR=3.36, HR=3.96). Patients with≥80 years old ( HR=1.22, HR=1.33) had a significant increase in the risk of postoperative complications and serious complications ( P < 0.05). Long-term dialysis ( HR=2.20, HR=2.13), long-term application of glucocorticoids ( HR=1.51, HR=2.27) patients had significant risk of complications and serious complications ( P < 0.01). Local anesthesia monitor ( HR=0.63, HR=0.67) reduced the risk of postoperative complications and serious complications (P<0.05). The risk of complications and serious complicationsin patients receiving hernia repair with moderate mFI ( HR=1.88, HR=2.01) and high mFI ( HR=2.12, HR=2.80) was significantly higher than that in patients with lower mFI ( P<0.01). The risk of complications and serious complications in patients of breast cancer with moderate mFI ( HR=1.76, HR=2.43) and high mFI ( HR=1.97, HR=2.38) was significantly higher than that in patients of breast cancer with low mFI ( P<0.01). Patients of thyroid cancer with a high mFI ( HR=6.38) showed a significantly higher risk of postoperative complications, compared with those with a low mFI (P<0.01). Conclusions For patients undergoing surgery for hernia, breast cancer, and thyroid cancer, weakness is associated with perioperative complications.%目的 探讨虚弱对普外科甲状腺、乳腺、疝气手术围手术期并发症影响的研究.方法 随机选取2014年5月至2017年5月入住辽宁省人民医院甲状腺乳腺外科的患者.记录每例患者的人口变量,将人口变量分层,每组人群都做虚弱指数(mFI)评分,以出现并发症及严重并发症为因变量,将各人口变量及mFI评分作为协变量,做协变量与因变量的Cox比例风险回归分析,将协变量分层,并做各亚组之间风险因素的比较.结果 共有1 408例患者符合上述纳入标准入选,其中女性801例,年龄(59.7 ± 11.6)岁,体质量指数(BMI)为(28.7 ± 7.4)kg/m2.中等mFI较低mFI出现并发症及严重并发症风险增高(HR=1.60,HR=2.10;P＜0.01),高mFI较低mFI出现并发症及严重并发症风险增高(HR=3.36,HR=3.96;P＜0.01).≥80岁患者术后出现并发症及严重并发症风险增高(HR=1.22,HR=1.33;P＜0.05).长期透析患者出现并发症及严重并发症风险显著增高(HR=2.20,HR=2.13;P＜0.01).长期应用糖皮质激素患者出现并发症及严重并发症风险显著增高(HR=1.51,HR=2.27;P＜0.01).监测下局部麻醉降低术后出现并发症及严重并发症的风险(HR=0.63,HR=0.67;P＜0.05).疝气修补术患者中等mFI(HR=1.88,HR=2.01)、高mFI(HR=2.12,HR=2.80)较低mFI出现的并发症及严重并发症风险显著增高(P＜0.01).乳腺癌患者中等mFI(HR=1.76,HR=2.43)、高mFI(HR=2.38)较低mFI出现的并发症及严重并发症风险显著增高(P＜0.01).甲状腺癌患者高mFI出现术后并发症风险较低mFI增高(HR=6.38, P＜0.01).结论 对于接受疝气、乳腺癌、甲状腺癌手术的患者而言,虚弱与围手术期并发症有关.
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