■广泛的皮下气肿可能导致住院时间明显延长,化妆品问题,甚至死亡没有及时治疗。然而,它的危险因素研究很少。
■阐明电视胸腔镜肺切除术后广泛皮下气肿的患病率和危险因素。
■这是一项回顾性配对病例对照研究。从2018年10月至2020年10月在中国一家三级教学医院收治的4339名胸外科患者中招募了86例病例和258名匹配对照。病例为通过电视胸腔镜手术进行肺切除术后诊断为广泛皮下气肿的患者。根据年龄和性别,对照组与病例的匹配比例为3:1。
■在这项研究中,广泛皮下气肿的发生率为2.05%,约75.58%的病例发生在术后1~4天。在单变量分析中,广泛皮下气肿患者的体重指数也可能显著降低,肺功能恶化,术中失血量较大,更长的操作时间,肺部手术史,更广泛的手术范围,和更广泛的胸膜粘连。多因素logistic回归分析结果显示,节段切除术(OR=3.130,95%CI:1.055-9.283,p=0.040),肺叶切除术(OR=4.487,95%CI:1.704-11.812,p=0.002),和广泛的胸膜粘连(OR=4.514,95%CI:1.763-11.556,p=0.002)是独立的危险因素。
■节段切除术,肺叶切除术,和广泛的胸膜粘连被认为是电视胸腔镜手术后广泛皮下气肿的独立危险因素。
UNASSIGNED: Extensive subcutaneous emphysema may lead to a significantly prolonged hospital stay, cosmetic problems, and even death without timely treatment. However, the risk factors for it have been poorly studied.
UNASSIGNED: To clarify the prevalence and risk factors of extensive subcutaneous emphysema after pulmonary resection by video-assisted thoracoscopic surgery.
UNASSIGNED: This is a retrospective matched
case-control study. A sample of 86 cases and 258 matched controls was recruited from among 4339 patients admitted to the thoracic surgery department from October 2018 to October 2020 in a tertiary teaching hospital in China. Cases were patients who were diagnosed with extensive subcutaneous emphysema after pulmonary resection through video-assisted thoracoscopic surgery. Controls were matched in a ratio of 3 : 1 to the cases based on age and sex.
UNASSIGNED: In this study, the incidence rate of extensive subcutaneous emphysema was 2.05%, and approximately 75.58% of the cases occurred within 1 to 4 days postoperatively. In univariate analysis, patients with extensive subcutaneous emphysema were also likely to have a significant lower body mass index, worse pulmonary function, greater intraoperative blood loss, longer time of operation, history of lung surgery, wider scope of surgery, and more extensive pleural adhesion. The results of multivariate logistic regression showed that segmentectomy (OR = 3.130, 95% CI: 1.055-9.283, p = 0.040), lobectomy (OR = 4.487, 95% CI: 1.704-11.812, p = 0.002), and extensive pleural adhesion (OR = 4.514, 95% CI: 1.763-11.556, p = 0.002) were independent risk factors.
UNASSIGNED: Segmentectomy, lobectomy, and extensive pleural adhesions were identified as independent risk factors for extensive subcutaneous emphysema after video-assisted thoracoscopic surgery.