肺癌术后发生呼吸衰竭（RI）的常见危险因素分析

摘要

目的：探析肺癌术后发生呼吸衰竭的常见因素。方法选取该院2011年1月-2015年1月收治的89例肺癌术后发生呼吸衰竭的患者为研究的对象，并同时选取同期手术治疗的178例肺癌术后未发生呼吸衰竭的患者，作为对照组，采取Logistic回归分析危险因素。结果研究组患者的平均年龄、平均吸烟量均显著多于对照组，差异有统计学意义(P<0.05)，研究组血浆白蛋白量为(36.5±4.3)g/L,对照组血浆白蛋白量为(35.4±3.3)g/L,两者差异无统计学意义(P<0.05)，研究组具有既往呼吸系统疾病史患者占(29/89)32.58%较对照组(5/178)2.81%差异有统计学意义(χ2=16.785，P<0.05)；研究组FEV1/FVC、FEF50%(约70%)的比例显著高于对照组，差异有统计学意义(P<0.05)，研究组MVV(约50%)、FIF50%、ERV、IC(约70%)较对照组比较，差异有统计学意义(P<0.05)。研究组患者术中输液量、术后当天输液量、术后当天进入量均显著高于对照组，差异有统计学意义(P<0.05)。 Logistic回归分析，患者年龄、既往呼吸系统疾病史、手术方式、FVC、FEV1及术后当天进入量是肺癌术后发生呼吸功能衰竭的常见危险因素。结论肺癌术后发生呼吸衰竭的常见因素中，年龄、既往呼吸道疾病史、手术方式、FVC、FEV1及术后当天进入量是其主要危险因素。%Objective To analyze the common factors causing postoperative respiratory failure in patients with lung cancer surgery. Methods 89 cases with respiratory failure after lung cancer surgery admitted in our hospital from January 2011 to January 2015 were selected as the subjects of the study group. And 178 cases underwent lung cancer surgery without postoperative respiratory failure during the same period were selected as the control group. And logistic regression analysis was used to analyze the risk fac-tors of postoperative respiratory failure. Results Compared with the control group, the study group had older mean age and greater average amount of smoking with statistically significant difference, P<0.05. The level of plasma albumin was (36.5±4.3) g/L in the study group, (35.4±3.3) g/L in the control group, the difference was not statistically significant, P>0.05. 32.58% (29/89) of the pa-tients in the study group had previous history of respiratory disease, while 2.81%(5/178) in the control group had that (χ2=16.785, P<0.05). The proportion of patients with FEV1/FVC, FEF50%(<70%) in the study group was much higher than that in the control group, P<0.05. There was statistically significant difference in the MVV(<50%), FIF50%, ERV, IC(<70%) between the study group and the control group, respectively, P<0.05. The intraoperative infusion volume, infusion volume and intake on the day after surgery in the study group was much more than that in the control group, respectively, P<0.05. Logistic regression analysis showed that age, previous history of respiratory disease, surgical approach, FVC, FEV1 and the intake on the day after surgery are the main risk factors of respiratory failure after lung cancer surgery. Conclusion Age, previous history of respiratory disease, surgical approach, FVC, FEV1 and the intake on the day after surgery are the main risk factors of respiratory failure after lung cancer surgery.