摘要
目的 探讨食管癌根治术后急性呼吸衰竭危险因素及其诊断价值。方法 收集食管癌根治术治疗的患者89例。再根据食管癌根治术后是否发生急性呼吸衰竭进行分组,即食管癌根治术后未发生急性呼吸衰竭的患者作为对照组,食管癌根治术后发生急性呼吸衰竭的患者作为观察组。收集患者术前及术中一般资料信息。采用Logistic回归分析食管癌根治术后急性呼吸衰竭危险因素,ROC曲线分析食管癌术后呼吸衰竭预测模型。结果 两组患者一般资料在性别、年龄、身高、高血糖、高血脂、高血压、FEV1方面进行比较,差异均无统计学意义(P>0.05);两组患者在BMI、吸烟指数、肺功能损伤方面比较,差异均具有统计学意义(P<0.05)。两组患者手术吻合部位、术前感染、其他手术并发症、手术时间方面进行比较,差异均无统计学意义(P>0.05);两组患者在肺部手术史、术中出血量以及术后机械通气时间方面比较,差异均具有统计学意义(P<0.05)。Logistic回归分析显示,吸烟指数、肺部手术史、术中出血量、术后机械通气时间均为食管癌根治术后急性呼吸衰竭危险因素。食管癌根治术后急性呼吸衰竭概率预测模型为P=1/[1+e(45.951-3.562吸烟指数-0.123术中出血量-4.65肺部手术史-1.165机械通气时间)]。新变量P的AUC为0.992,且诊断效果均高于吸烟指数、术中出血量、肺部手术史以及术后机械通气时间。P的敏感度为96.7%、特异度为95.8%。结论 进行食管癌根治术治疗的患者,联合检测多项危险因素可以有效提高术后发生急性呼吸衰竭的诊断价值。
Objective To investigate the risk factors and diagnostic value of acute respiratory failure after radical resection of esophageal cancer.Methods A total of 89 patients with esophageal cancer treated by radical resection were collected.Patients without acute respiratory failure after radical esophagectomy were the control group and patients with acute respiratory failure after radical esophagectomy were the observation group.The preoperative and intraoperative general data of the patients were collected.Logistic regression was used to analyze the risk factors of acute respiratory failure after radical resection of esophageal cancer,and ROC curve was used to analyze the predictive model of respiratory failure after radical resection of esophageal cancer.Results There were no significant differences in gender,age,height,hyperglycemia,hyperlipidemia,hypertension and FEV1 between the 2 groups(P>0.05).There were statistically significant differences in BMI,smoking index and lung function injury between the 2 groups(P<0.05).There were no significant differences in anastomotic site,preoperative infection,other surgical complications and operation time between the 2 groups(P>0.05).There were statistically significant differences in pulmonary operation history,intraoperative blood loss and postoperative mechanical ventilation time between the 2 groups(P<0.05).Logistic regression analysis showed that smoking index,pulmonary surgery history,intraoperative blood loss and postoperative mechanical ventilation time were risk factors for acute respiratory failure after radical resection of esophageal cancer.The predictive model for the probability of acute respiratory failure after radical resection of esophageal cancer was P=1/[1+e(45.951-3.562 smoking index-0.123 intraoperative blood loss-4.65 history of pulmonary surgery-1.165 duration of mechanical ventilation)].The AUC of the new variable P was 0.992,and the diagnostic effect was higher than that of smoking index,intraoperative blood loss,pulmonary surgery history and postoperative mechanical ventilation time.The sensitivity and specificity of P were 96.7% and 95.8%,respectively.Conclusion In patients undergoing radical resection of esophageal cancer,joint detection of multiple risk factors can effectively improve the diagnostic value of acute respiratory failure after surgery.
作者
关敬彬
尚晓辉
张珉
GUAN Jingbin;SHANG Xiaohui;ZHANG Min(Affiliated Cancer Hospital of Zhengzhou University(Henan Cancer Hospital),Zhengzhou,450008)
出处
《实用癌症杂志》
2023年第4期634-637,共4页
The Practical Journal of Cancer
关键词
食管癌根治术
急性呼吸衰竭
危险因素
诊断价值
Radical resection of esophageal cancer
Acute respiratory failure
Risk factors
Diagnostic value
