新型冠状病毒肺炎(COVID-19)术后肺癌患者肺部感染相关因素分析

Ling Wang, Hailian Li, Lili Qin, Caiquin Liu
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摘要

目的:探讨新型冠状病毒肺炎(COVID-19)术后肺癌患者肺部感染的相关因素,为预防和降低肺癌患者术后肺部感染的发生率提供方法。方法:选取宜昌市中心人民医院心胸外科于2023年1月28日至2023年3月3日行肺癌手术的患者92例。根据是否发生肺部感染分为肺部感染组(47例)和非肺部感染组(45例)。收集整理患者的一般临床资料,分析新冠肺炎康复后肺癌患者肺部感染的相关影响因素。结果:单因素分析显示,患者年龄(≥60岁)、感染后发热、口腔咽喉症状、消化道症状、神经系统症状、长期吸烟史、高血压史、手术时间(≥3 h)与肺部感染相关(均P < 0.05)。术后肺部感染与性别、眼、鼻、舌症状、全身症状、COVID-19病程、COPD、肺叶切除部位、切口疼痛、机械通气时间(≥6 h)、引流管保留时间(3 d)、手术方式无显著相关性(P < 0.05)。Logistic多因素分析显示,年龄(≥60岁)、手术时间长(≥3 h)、长期吸烟史是肺癌根治术后肺部感染的独立影响因素(P < 0.05)。结论:本研究中,年龄较大(≥60岁)、长期吸烟史、手术时间长(≥3 h)是肺癌术后肺部感染的危险因素。今后围手术期可采取积极的治疗措施解决这些危险因素,降低术后肺部感染的发生率。
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Analysis of factors related to postoperative pulmonary infection in lung cancer patients after recovery from COVID-19
Objective: To explore factors related to postoperative pulmonary infection in lung cancer patients after recovery from COVID-19 and to provide methods for preventing and reducing the incidence of postoperative lung infection in patients with lung cancer. Methods: A total of 92 patients who underwent lung cancer surgery in the Department of Thoracic and Cardiac Surgery of Yichang Central People’s Hospital from January 28, 2023, to March 3, 2023, were selected. They were divided into a pulmonary infection group (47 cases) and a nonpulmonary infection group (45 cases) according to whether pulmonary infection occurred. General clinical data of patients were collected and collated to analyse the related influencing factors of pulmonary infection in lung cancer patients after recovery from COVID-19. Results: Univariate analysis showed that patient age (≥ 60 years), fever after COVID-19 infection, oral and laryngeal symptoms, digestive tract symptoms, neurological symptoms, long-term smoking history, hypertension history, and operation time (≥ 3 h) were correlated with pulmonary infection (all P < 0.05). There was no significant correlation between postoperative pulmonary infection and sex, ocular, nasal and tongue symptoms, systemic symptoms, duration of COVID-19, COPD, lobectomy site, incision pain, mechanical ventilation time (≥ 6 h), drainage tube retention time (3 d), surgical method( P > 0.05). Logistic multivariate analysis showed that age (≥60 years old), long operation time (≥ 3 h) and long-term smoking history were independent influencing factors for postoperative pulmonary infection in patients with radical resection of lung cancer ( P > 0.05). Conclusion: In this study, older age (≥ 60 years old), long-term smoking history, and long operation time (≥ 3 h) were risk factors for pulmonary infection after lung cancer surgery. In the future, active treatment measures can be taken to address these risk factors during the perioperative period to reduce the incidence of postoperative pulmonary infection.
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