| Objective:In recent years, lung cancer incidence and mortality were significantly increased. Timely detection and treatment are very important. Methods of treating lung cancer mainly include surgical treatment, chemotherapy and radiotherapy, Chinese medicine treatment and so on. The best treatment of early stage of lung cancer is surgical operation, surgical indications and operative types selected mainly according to the general conditions of invasion by tumor location and patient generally physical conditions especially cardiopulmonary functional reserve circumstances. The principle of operation is completely excision of the lesion, and to maximize the retention of healthy lung tissue. Early stage of lung cancer underwent radical resection should be systemic, to achieve goal of survival, in complete resection of primary cancer focus both clear the hilar lymph node at the same time and to protect the healthy lung tissue as much as possible, most of advanced lung cancer disease need to strive for surgical resection of the primary tumor, and removed lymph node metastasis as far as possible, and at the same time combined with the other treatment such as radiotherapy, chemotherapy. At present, only 20% of patients are suitable for surgery.Standard operation for lung cancer about lobectomy, sleeve lobectomy or total lung and the systematic removal of lymph node dissection, this point has achieved consensus. The traditional open chest operation trauma is huge, more bleeding,Long time operation, postoperative recovery is slow it is self-evident. All thoracoscopic lung cancer operation has more advantages than traditional operation. All thoracoscopic lung surgery can complete the anatomical level of tumor complete resection and lymph node dissection.Patients has higher life quality than traditional thoracotomy and the survival rate of the postoperative long-term is similar with traditional thoracotomy. All thoracoscopic lung surgery is bound to become the main way of surgery of lung cancer. To carry out the Da Vinci robot assisted thoracoscopic surgery to make up for the deficiency of video-assisted thoracoscopic surgery in part, due to anatomical characteristics of chest is very suitable for implantation instruments of surgery operation, so the application of robotic surgery in the Department of thoracic surgery leading to other surgical specialties and application prospects is optimism.Common complications after lung cancer operation:1.pulmonary complications:pulmonary infection, such as pulmonary edema, pulmonary embolism, acute respiratory failure; 2.cardiovascular complications:such as arrhythmia, heart failure, myocardial infarction, cardiac arrest and pulmonary embolism; 3.gastrointestinal complications; 4.other complications such as postoperative:hemorrhage, mental state of patients with urine retention after anesthesia, postoperative complications such as mental stress anomaly. The rate of heart and lung complications is higher, It must be treated timely and effectively becacuse patients postoperative recovery will be caused serious impact, and even endanger the lives of patients. At the same time, increase the difficulty of the work of clinical treatment. In view of the above situation, to explore the main risk factors of cardiopulmonary complications in preoperative period of postoperative lung cancer patients, in order to provide scientific basis for the prediction and treatment of preoperative cardiopulmonary complications in senile Lung Cancer.Methods:Using the method of retrospective study, the clinical data of 225 patients underwent lung cancer operation were collected. All patients underwent surgery, preoperative and intraoperative or postoperative pathological confirmed lung cancer with complete clinical data. For patients with data analysis, to understand including arrhythmia, heart failure and other cardiac complications and pulmonary infection, pleural effusion, pleural hemorrhage, respiratory failure and other complications of lung in the pre operation period of occurrence and incidence and correlation,Through test of univariate and logistic regression analysis on multivariate factors for preoperative cardiopulmonary complications, the paper has investigated related risk factors for preoperative cardiopulmonary complications and assessed relationship between preoperative cardiopulmonary complications and other common risk factors, and then drew the conclusion. Statistical analysis was analysised by using SPSS13.0 version software package. A probability level of 5% was considered significant.Results:Among 225 cases of lung cancer patients, Postoperative thoracic closed drainage tube indwelling days for 4-29 d, the average 7.58d; postoperative hospital stay was 5-47d, the average 13.5d. The postoperative cardiopulmonary complications occurred in 148 cases with incidence rate of 65.7%, of which 1 patients were dead. Among the 71 cases of arrhythmia, mainly about atrial fibrillation, rapid heart rate, ventricular premature beat, atrial premature beat, atrioventricular block and other arrhythmias, heart failure in 8 cases,105 cases of pulmonary infection,32 cases of pulmonary atelectasis, pleural effusion in 61 cases,25 cases of pneumothorax,3 cases with respiratory failure,2 cases of bronchopleural repeatedly and 1 cases of pulmonary embolism. The study collected and analyzed 15 potentially relevant factors in preoperative, intraoperative, postoperative periods. As a result, in cardiac complications, there were no significant difference with regard to gender, age, smoking index, preoperative hypertension and operation mode (P>0.05). In addition to the above 5 items, patients characterized with preoperative cardiac arrhythmia, resection range, operative time, blood loss, postoperative lung infection, pleural effusion, and pneumothorax were more likely get preoperative cardiac complications(P<0.05). The results showed that the choice of operation mode, operative time, blood loss above and postoperative lung infection, pleural effusion, and pneumothorax had the larger impact to patients. In the pulmonary complications:there were no significant difference with regard to gender, preoperative hypertension, preoperative cardiac arrhythmia and the amount of bleeding during operation (P>0.05). The differences of age, smoking, preoperative pulmonary emphysema, preoperative FEV1, operation mode, operation excision scope, operation time and postoperative arrhythmia had statistically significance (P<0.05). The results showed that the above 8 indicators were risk factors of preoperative pulmonary complications in lung cancer.Conclusions:1 Age, preoperative lung function, preoperative cardiac arrhythmia, preoperative pulmonary emphysema, open chest operation mode, operation lasting time, intraoperative bleeding volume, postoperative pleural effusion, postoperative pneumothorax is the key factor in patients with lung cancer postoperative postoperation period prone to complicate risk factors of lung and heart.2 A comprehensive assessment of the risk factors for lung cancer patients before surgery can help predict the occurrence of cardiac and pulmonary complications preliminarily, which is of great significance to preoperative treatment of senile lung cancer. |
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