老年男性肺癌患者胸腔镜术后新发房颤危险因素分析

Analysis of Risk Factors for Newly Developed Atrial Fibrillation after Thoracoscopic Resection in Elderly Male Patients with Lung Cancer

摘要: 目的：探讨老年男性肺癌患者胸腔镜切除术后新发房颤(POAF)的危险因素。方法：回顾性分析2023年4月至2024年4月青岛大学附属医院胸外科收治的237例行胸腔镜切除术的老年男性肺癌患者临床资料，根据胸腔镜术后是否发生房颤分为术后房颤组和非房颤组，其中术后房颤组40例，非房颤组197例，通过病历系统采集围手术期相关指标，并进行单因素分析，并将P < 0.05的变量纳入多因素logistic回归模型中，筛选发生术后房颤的独立危险因素。结果：老年男性肺癌患者胸腔镜切除术后房颤(P0AF)发生率为16.87% (40/237)。多因素logistic回归分析结果显示，年龄(OR = 1.161, P = 0.01)、静息心率(OR = 1.058, P = 0.017)、合并慢性阻塞性肺疾病(OR = 3.488, P = 0.036)、白介素-6 (OR = 1.013, P = 0.002)、肿瘤最大径(OR = 1.052, P = 0.001)、引流管留置时间(OR = 1.293, P = 0.001)是老年男性肺癌患者胸腔镜切除术后发生房颤的独立危险因素。结论：年龄、静息心率、引流管留置时间、IL-6、合并慢性阻塞性肺疾病是老年男性肺癌患者胸腔镜切除术后发生房颤的独立危险因素，P0AF与更长的术后住院时间有关。

Abstract: Objective: to explore the risk factors of new-onset atrial fibrillation (POAF) after thoracoscopic resection in elderly male lung cancer patients. Methods: The clinical data of 237 elderly male lung cancer patients who underwent thoracoscopic resection admitted to the Department of Thoracic Surgery of Affiliated Hospital of Qingdao University from April 2023 to March 2024 were retrospectively analyzed, and they were divided into postoperative atrial fibrillation (POAF) group and non-atrial fibrillation (NOAF) group according to the whether or not atrial fibrillation occurred after thoracoscopic resection, among which there were 40 cases of postoperative atrial fibrillation and 197 cases of non-atrial fibrillation. factor analysis, and the variables with P < 0.05 were included in the multifactor logistic regression model to screen the independent risk factors for the occurrence of postoperative atrial fibrillation. Results: The incidence of postoperative atrial fibrillation (P0AF) after thoracoscopic resection in elderly male lung cancer patients was 16.87% (40/237). Multifactorial Logistic regression analysis showed that age (OR = 1.161, P = 0.01), resting heart rate (OR = 1.058, P = 0.017), comorbid chronic obstructive pulmonary disease (OR = 3.488, P = 0.036), interleukin-6 (OR = 1.013, P = 0.002), maximal tumor diameter (OR = 1.052, P = 0.001), and drain retention time (OR = 1.293, P = 0.001) were independent risk factors for the development of atrial fibrillation after thoracoscopic resection in elderly male lung cancer patients. Conclusion: Age, resting heart rate, drain retention time, interleukin-6, and comorbid chronic obstructive pulmonary disease were independent risk factors for the development of atrial fibrillation after thoracoscopic resection in elderly male patients with lung cancer, and P0AF was associated with longer postoperative hospitalization.