单肺通气参数与肺癌根治术后肺部感染的相关性：一项回顾性队列研究
Association between one-lung ventilation parameters and postoperative pulmonary infection after radical lung cancer surgery: A retrospective cohort study.
作者
作者单位
- Department of Anesthesiology, Zhejiang Jinhua Guangfu Tumor Hospital, Jinhua 321000, China.
- Department of Thoracic Surgery, Zhejiang Jinhua Guangfu Tumor Hospital, Jinhua 321000, China.
- Department of Thoracic Surgery, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha 410005, China.
摘要
中文
探讨单肺通气（OLV）期间肺保护参数与肺癌（LC）根治术后肺部感染（PPI）风险之间的关系。本回顾性研究纳入2022年1月1日至2025年12月31日期间接受OLV下LC根治术的319例非小细胞肺癌患者。根据术后住院期间是否发生PPI，将患者分为PPI组（n=35）和非PPI组（n=284）。收集基线数据、术前肺功能及术中OLV参数。采用Logistic回归分析确定相关因素，并通过受试者工作特征（ROC）曲线评估多变量模型的区分能力。PPI发生率为11.0%。与非PPI组相比，PPI组年龄较大、高血压比例较高、第一秒用力呼气容积（FEV1）和呼气峰流速（PEF）较低、开胸手术比例较高、潮气量（VT）较高、吸气压力较高、通气频率较高、吸入氧浓度（FiO₂）较高，但呼气末正压（PEEP）较低（均P < 0.05）。多因素Logistic回归分析显示，高血压、FEV1降低、开胸手术、吸气压力较高和FiO₂较高与PPI独立相关（均P < 0.05）。基于这些独立因素构建的模型AUC为0.856（95% CI：0.782-0.906）。OLV期间的肺保护参数与LC根治术后PPI相关。值得注意的是，在校正混杂因素后，较高的吸气压力和较高的FiO₂仍与PPI独立相关。
English
To investigate the relationship between lung-protective parameters during one-lung ventilation (OLV) and the risk of postoperative pulmonary infection (PPI) after radical lung cancer (LC) surgery. This retrospective study included 319 patients with non-small cell lung cancer who underwent radical LC surgery with OLV during January 1, 2022-December 31, 2025. Patients were divided into PPI (n = 35) and non-PPI (n = 284) groups based on whether PPI occurred during postoperative hospitalization. Baseline data, preoperative pulmonary function, and intraoperative OLV parameters were collected. Logistic regression analyses were performed to identify relevant factors. The discriminatory ability of the multivariate model was evaluated using the ROC curve. The incidence of PPI was 11.0%. Compared with the non-PPI group, the PPI group had older age, a higher proportion of hypertension, lower forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF), a higher proportion of open thoracic surgery, higher tidal volume (VT), higher inspiratory pressure, higher ventilation frequency, and higher fraction of inspired oxygen (FiO₂), but lower positive end-expiratory pressure (PEEP) (all P < 0.05). Multivariate logistic regression analysis showed that hypertension, lower FEV1, open thoracic surgery, higher inspiratory pressure, and higher FiO₂ were independently associated with PPI (all P < 0.05). The AUC of the model constructed based on these independent factors was 0.856 (95% CI: 0.782-0.906). Lung-protective parameters during OLV are associated with PPI after radical LC surgery. Notably, higher inspiratory pressure and higher FiO₂ remain independently associated with PPI after adjusting for confounding factors.
分类与指标
- 研究类型
- 临床研究
- 病种
- 肺癌
- JCR 分区
- Q3
- 影响因子
- 1.4
- 新锐分区
- 3区