摘要
目的对老年食管癌患者在胸腔镜手术术后发生的急性肺损伤(ALI)原因进行探究。方法对2018年1月至2022年5月期间210例老年食管癌病例的临床资料进行系统性回顾性梳理,依据患者术后是否发生急性肺损伤将其划分为不同组别,深入探讨相关影响因素,并运用χ^(2)检验及Logistic回归模型进行统计学分析。结果210例老年食管癌患者中,共49例并发ALI,发生率是23.33%,161例无ALI,对比ALI组与非ALI组间一般资料,显示性别、基础疾病、吸烟、肿瘤位置、临床分期、吻合部位经对比未有差异(P>0.05),患者年龄、气管插管时间、清扫淋巴结数目、白蛋白水平具有差异(P<0.05),由单因素条件Logistic分析发现和胸腔镜术后食管癌并发ALI具有相关性,再将上述存在差异指标带入多因素回归分析中,年龄、气管插管时间、白蛋白、清扫淋巴结数目均是影响老年食管癌患者术后并发ALI独立因素。结论老年食管癌患者在进行胸腔镜手术时,面临较高的ALI风险,该风险与插管时长、年龄大小、血清白蛋白水平以及切除淋巴结的数量有关,应对存在上述危险因素的患者严密监测,加强围手术期管理,并提供针对性措施,以降低ALI发生。
Objective To investigate the causes of acute lung injury(ALI)in elderly esophageal cancer patients after thoracoscopic surgery.Methods A systematic retrospective review was conducted on 210 elderly esophageal cancer cases from January 2018 to May 2022.Patients were categorized into different groups based on whether they developed postoperative ALI.The study explored relevant influencing factors and employed χ^(2) test and Logistic regression model for statistical analysis.Results Of the 210 elderly patients with oesophageal cancer,A total of 49 concurrent ALI cases,The incidence rate was 23.33%,In 161 patients without ALI,Comparing the general data between the ALI group and the non-ALI groups,There was no difference in gender,underlying disease,smoking,tumor location,clinical stage,and anastomotic site(P>0.05),Patient age,endotracheal intubation time,number of dissected lymph nodes,and albumin level were different(P<0.05),The association of esophageal cancer with ALI,Then the above difference indicators were brought into the multifactor regression analysis,Age,time of tracheal intubation,albumin,and number of dissected lymph nodes were all independent factors affecting postoperative ALI in elderly patients with esophageal cancer.Conclusion Elderly patients with esophageal cancer have a high risk of ALI,and endotracheal intubation time,age,albumin,and number of lymph lymph nodes are all the influencing factors.Patients with the above risk factors should be closely monitored,strengthened perioperative management,and targeted measures should be provided to reduce the occurrence of ALI.
作者
徐梦云
章子祎
XU Meng-yun;ZHANG Zi-yi(Operating Room,the First Affiliated Hospital of Nanchang University,Nanchang 330000,Jiangxi Province,China)
出处
《罕少疾病杂志》
2026年第1期86-88,共3页
Journal of Rare and Uncommon Diseases
关键词
食管癌
老年
胸腔镜
急性肺损伤
Esophageal Cancer
Aging
Thoracoscopy
Acute Lung Injury
