摘要
目的探讨肥胖对肺切除术后并发症发生和手术死亡率的影响。方法回顾性分析2003年9月至2007年12月上海市肺科医院3 494例肺部疾病行肺切除术患者的临床资料,依据体重指数(body mass index,BMI)不同将3 494例患者分为两组,非肥胖组(BMI<28 kg/m2):3 340例,男2 502例,女838例;年龄(61.9±10.7)岁;肥胖组(BMI≥28 kg/m2):154例,男87例,女67例;年龄(59.7±9.6)岁。通过单因素和logistic多因素回归分析肥胖(BMI≥28 kg/m2)对肺切除术后并发症发生的影响。结果围术期共死亡26例,其中非肥胖组死亡23例,肥胖组死亡3例,两组患者的病死率比较差异无统计学意义[0.7%(23/3 340)vs.1.9%(3/154),P=0.118]。两组患者任一并发症和呼吸系统并发症发生率比较差异均无统计学意义(P>0.05)。除呼吸系统外,肥胖组患者其它系统并发症发生率显著高于非肥胖组(P<0.05),脑血管意外、心肌梗死和急性肾功能衰竭发生率高于非肥胖组(P<0.05)。Logistic多因素回归分析结果显示:肥胖(BMI≥28 kg/m2)不是肺切除术后并发症发生的独立危险因素[回归系数为0.648、OR值为1.911,95%CI(0.711,5.138),P值为0.199]。结论肥胖不引起肺切除术后手术死亡率和并发症发生率的显著增高。
Objective To explore the impact of obesity on postoperative morbidity and mortality after pneumonec- tomy. Methods Clinical data of 3 494 patients with pulmonary diseases who underwent pneumonectomy in Shanghai Pulmonary Hospital from September 2003 to December 2007 were retrospectively analyzed. All the 3 494 patients were divided into two groups according to the patients＇ preoperative body mass index （BMI）. There were 3 340 patients in the non-obesity group （BMI 〈 28 kg/m^2） including 2 502 males and 838 females with their average age of 61.9 ± 10.7 years, and 154 patients in the obesity group （BMI ≥ 28 kg/m^2） including 87 males and 67 females with their average age of 59.7±9.6 years. Univariate analysis and logistic regression were used to analyze the impact of obesity （BMI ≥ 28 kg/m2） on postoperative morbidity after pneumonectomy. Results There were a total of 26 cases ofperioperative death, including 23 patients in the non-obesity group and 3 patients in the obesity group. There was no statistical difference in mortality be- tween the two groups [ 0.7% （23/3 340 ） vs. 1.9% （3/154）, P=0.1181. There was no statistical difference in any particular postoperative morbidity or incidence of pulmonary complications between the two groups （P 〉 0.05）. Other than pulmo- nary complications, the incidence of postoperative complication in other body systems of the obesity group was significant higher than that of the non-obesity group （P 〈 0.05）. The incidence of cerebrovascular accidents, myocardial infarction and acute renal failure of the obesity group was significant higher than those of the non-obesity group （P 〈 0.05 ）. Logistic regression showed that obesity （BMI ≥ 28 kg/m^2） was not an independent risk factor for postoperative morbidity after pneumonectomy [B：0.648, 0R：1.911,95% CI （0.711, 5.138）, P=0.199 ]. Conclusion Obesity is not a significant risk factor of postoperative mortality or morbidity after pneumonectomy.
出处
《中国胸心血管外科临床杂志》
CAS
2013年第1期74-77,共4页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
关键词
肺切除术
肥胖
术后并发症
死亡率
Pneumonectomy
Obesity
Postoperative morbidity
Mortality
