文章摘要
孟祥荷 ,王翠 ,连亚军 ,刘洪波 ,李钰娟 ,杜丽媛 ,刘凤霞 ,谢南昌.肺癌患者肺叶切除术后发生脑梗死危险因素的相关研究[J].神经损伤功能重建,2022,17(10):582-586
肺癌患者肺叶切除术后发生脑梗死危险因素的相关研究
Analysis of Risk Factors Related to Cerebral Infarction after Pulmonary Lobectomy in Pa⁃tients with Lung Cancer
  
DOI:
中文关键词: 肺癌  脑梗死  肺叶切除术  危险因素  肺静脉血栓
英文关键词: lung cancer  cerebral infarction  pulmonary lobectomy  risk factors  pulmonary vein thrombosis
基金项目:国家自然科学基金 (No. 81971214,81 701272)
作者单位
孟祥荷1 ,王翠2a ,连亚军2b ,刘洪波2b ,李钰娟2b ,杜丽媛2b ,刘凤霞2b ,谢南昌2b 1. 河北省人民医院 神经介入科 2. 郑州大学第一附 属医院a.临床检验 科b. 神经内科 
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中文摘要:
      目的:探讨肺癌患者肺叶切除术后发生脑梗死的危险因素。方法:连续收集并前瞻性登记2016年11 月至2018年11月于郑州大学第一附属医院接受肺叶切除术的肺癌患者708例,术后随访6个月。根据在随 访期间是否发生脑梗死,患者分为脑梗死组和对照组;收集2组的临床资料分别进行单因素分析和多因素 Logistic回归分析。结果:纳入脑梗死组12例(1.7%),对照组696例(98.3%)。单因素分析显示:脑梗死组 糖尿病和高脂血症患者的比例高于对照组(P<0.05);2组的病灶切除部位、手术方式差异有统计学意义 (P<0.05),其他指标差异无统计学意义(P>0.05)。多因素Logistic分析显示:在调整了年龄、性别、吸烟 史、高血压、房颤、冠心病、术后抗凝治疗、手术持续时间和住院时长后,左上肺叶切除术(OR=10.670,95% CI 2.021~56.325,P=0.005)、左全肺切除术(OR=13.726,95%CI 1.398~134.746,P=0.025),糖尿病(OR= 6.021,95%CI 1.483~24.436,P=0.012)和高脂血症(OR=6.786,95% CI 1.337~34.455,P=0.021)与肺癌患者 术后发生脑梗死独立相关。结论:左上肺叶切除术、左全肺切除术、糖尿病病史和高脂血症病史可能是肺 癌患者肺叶切除术后发生脑梗死的独立危险因素。
英文摘要:
      To investigate the risk factors of cerebral infarction in patients with lung cancer after pulmonary lobectomy. Methods: A total of 708 consecutive patients with lung cancer who underwent pulmonary lobectomy at the First Affiliated Hospital of Zhengzhou University from November 2016 and November 2018 were prospective registered and followed up for 6 months. According to whether complicated by postoperative cerebral infarction, the patients were classified into the cerebral infarction group or control group. Clinical data was collected, and single factor analysis and multi-factor Logistic regression analysis were performed to determine independent predictors for postoperative stroke. Results: Twelve cases (1.7%) were included in the cerebral infarction group and 696 cases (98.3%) in the control group. The cerebral infarction group showed a greater proportion of patients with diabetes mellitus and hyperlipidemia compared to the control group (P<0.05). There were significant differences between the two groups in resection site and surgical method (P<0.05). Other factors showed no significant difference (P>0.05). Multivariate Logistic regression analysis adjusted for age, gender, history of smoking, hypertension, atrial fibrillation, coronary heart disease, postoperative anticoagulation therapy, surgery length, and hospitalization time showed that left upper lobectomy (OR=10.670, 95% CI: 2.021-56.325, P=0.005), left pneumonectomy (OR=13.726, 95% CI: 1.398-134.746, P=0.025), diabetes mellitus (OR=6.021, 95% CI: 1.483-24.436, P=0.012), and hyperlipidemia (OR=6.786, 95% CI: 1.337-34.455, P=0.021) were independent predictors of postoperative cerebral infarction. Conclusion: Left upper lobectomy, left pneumonectomy, diabetes, and hyperlipidemia may be significant risk factors for postoperative cerebral infarction in patients with lung cancer.
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