肺癌术后心律失常的危险因素分析

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[目的]探讨肺癌术后心律失常的危险因素,为肺癌术后心律失常的防治提供科学依据。[方法]回顾性分析188例行肺癌切除术患者的临床资料,对肺癌术后发生心律失常的相关因素进行Logistic回归分析,筛选出肺癌术后心律失常的危险因素。[结果]术后心律失常的发生率为32.45%(61/188)。经多因素Logistic回归分析发现,年龄(≥65岁)、吸烟史、心律失常史、术中心包损伤、全肺切除、术后肺不张等是肺癌术后心律失常的危险因素(P<0.05);而术后镇痛是保护因素(P<0.05)。[结论]对存在心律失常危险因素的高危肺癌患者,术前应积极治疗心肺并发症、改善心肺功能、戒烟;术中充分给氧,尽量减少对心肺的牵拉及挤压;术后加强心电监护、有效地镇痛,从而减少肺癌术后心律失常的发生。 [Objective] To explore the risk factors of postoperative arrhythmia in lung cancer and provide a scientific basis for the prevention and treatment of postoperative arrhythmia in lung cancer. [Methods] The clinical data of 188 patients undergoing resection of lung cancer were retrospectively analyzed. Logistic regression analysis was performed on the related factors of postoperative arrhythmia of lung cancer, and the risk factors of postoperative arrhythmia of lung cancer were screened out. [Results] The incidence of postoperative arrhythmia was 32.45% (61/188). Multivariate Logistic regression analysis found that age (≥65 years), history of smoking, history of arrhythmia, pericardial injury, pneumonectomy and postoperative atelectasis were the risk factors of postoperative arrhythmia (P <0.05 ); Postoperative analgesia was protective factor (P <0.05). [Conclusion] For patients with high-risk lung cancer who are at risk of arrhythmia, preoperative cardiopulmonary complications should be actively treated, heart and lung function should be improved, smoking cessation should be stopped, oxygen should be given during surgery to minimize the pulling and squeezing of heart and lung, postoperative heart strengthening Electrical monitoring, effective analgesia, thereby reducing the incidence of postoperative arrhythmia in lung cancer.
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