[1]马静 张远航 王思佳 高雪 包莉云 李葆华*.微创肺部手术后患者首次下床晕厥前兆预后因素的初步探索[J].中国微创外科杂志,2023,01(5):367-371.
　Ma Jing,Zhang Yuanhang,Wang Sijia,et al.Preliminary Exploration of Prognostic Factors of Syncope Precursor When Patients First Get Out of Bed After Minimally Invasive Pulmonary Surgery[J].Chinese Journal of Minimally Invasive Surgery,2023,01(5):367-371.
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微创肺部手术后患者首次下床晕厥前兆预后因素的初步探索()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2023年5期
页码:
367-371
栏目:
护理研究
出版日期:
2023-05-25

文章信息/Info

Title:
Preliminary Exploration of Prognostic Factors of Syncope Precursor When Patients First Get Out of Bed After Minimally Invasive Pulmonary Surgery
作者:
马静 张远航 王思佳 高雪 包莉云 李葆华*
(北京大学第三医院胸外科，北京100191)
Author(s):
Ma Jing;  Zhang Yuanhang;  Wang Sijia;  et al.
Department of Thoracic Surgery, Peking University Third Hospital, Beijing 100191, China
关键词:
肺部术后; 首次下床; 晕厥前兆; 预后因素
Keywords:
Postthoracic surgery; First get out of bed; Syncope precursor; Prognostic factor
文献标志码:
A
摘要:
目的探讨微创肺部手术后患者首次下床时发生晕厥前兆的预后因素。方法以2022年3~12月于我科行微创肺部手术的409例患者作为研究对象，术后首次下床出现低血压、头晕、大汗、恶心呕吐、黑矇、心悸中任意一项，即认定发生晕厥前兆。收集基本资料及手术相关指标，使用logistic回归分析发生晕厥前兆的预后因素。结果术后首次下床活动发生晕厥前兆94例(23.0%)，未发生晕厥前兆315例(77.0%)。logistic回归分析显示术后1日胸腔引流量为晕厥前兆发生的独立预后因素，术后1日胸腔引流量>300 ml者发生晕厥前兆的风险是<200 ml者的2.377倍(95% CI：1.111~5.087，P=0.026)。结论微创肺部手术后患者首次下床活动出现晕厥前兆的发生率较高，术后1日胸腔引流量是发生晕厥前兆的独立预后因素，引流量>300 ml提示晕厥发生风险高，需要注意避免这些患者晕厥后跌倒所致伤害。
Abstract:
ObjectiveTo investigate the prognostic factors for the occurrence of syncope precursor when patients first get out of bed after minimally invasive lung surgery.MethodsA total of 409 patients who underwent minimally invasive lung surgery in our department from March to December 2022 were selected. When patients first got out of bed at postoperation, occurrence of hypotension, dizziness, profuse sweating, nausea and vomiting, amaurosis, or palpitations was considered a syncope precursor. The basic data and surgeryrelated indicators were collected, and the logistic regression was utilized to analyze the prognostic factors for the occurrence of syncope precursor.ResultsWhen first got out of bed at postoperation, 94 cases (23.0%) showed syncope precursors and 315 cases (77.0%) presented without syncope precursor. The logistic regression analysis showed that postoperative oneday chest drainage was an independent prognostic factor for developing syncope precursor. The risk of syncope precursor was 2.377 times higher in those with postoperative oneday chest drainage >300 ml than those with <200 ml (95% CI: 1.111-5.087,P=0.026).ConclusionsThe incidence of syncope precursor in patients who first get out of bed after minimally invasive pulmonary surgery is high. Postoperative oneday chest drainage is an independent prognostic factor for syncope precursor, with drainage >300 ml indicating a high risk. Care needs to be taken to avoid injuries from falls after syncope in these patients.

参考文献/References:

[1]Kanzaki M.Current status of robotassisted thoracoscopic surgery for lung cancer.Surg Today,2019,49(10):795-802.
[2]佟冰渡,李高洋,田雪,等.青少年特发性脊柱侧凸患者术后首次离床活动直立不耐受的现状及影响因素分析.中国护理管理,2022,22(1):17-21.
[3]陆金美,赵莉,秦洁.品管圈活动降低术后患者首次下床晕厥前兆发生率.实用临床护理学电子杂志,2017,2(23):152-153.
[4]闫阳,刘美,周丹,等.快速康复理念在胸外科围手术期护理中的应用.实用临床护理学电子杂志,2019,4(19):114,125.
[5]Freeman R,Abuzinadah AR,Gibbons C,et al.Orthostatic hypotension:JACC stateoftheart review.J Am Coll Cardiol,2018,72(11):1294-1309.
[6]Hanada M,Tawara Y,Miyazaki T,et al.Incidence of orthostatic hypotension and cardiovascular response to postoperative early mobilization in patients undergoing cardiothoracic and abdominal surgery.BMC Surg,2017,17(1):111.
[7]翟正芹,周益锋.血管迷走性晕厥的机制、诊断和治疗.中华心律失常学杂志,2022,26(5):424-427.
[8]Deng X,Zhang Y,Liao Y,et al.Efficacy of βblockers on postural tachycardia syndrome in children and adolescents: a systematic review and metaanalysis.Front Pediatr,2019,7:460.
[9]Jorge JG,Raj SR,Teixeira PS,et al.Likelihood of injury due to vasovagal syncope:a systematic review and metaanalysis.Europace,2021,23(7):1092-1099.
[10]Jorge JG,Pournazari P,Raj SR,et al.Frequency of injuries associated with syncope in the prevention of syncope trials.Europace,2020,22(12):1896-1903.
[11]王振华,张立国,郭喜喜.单根胸腔引流管联合负压引流管在单操作孔胸腔镜肺癌根治术后的引流效果分析.医学临床研究,2021,38(3):365-367.
[12]于春好,王晓玲,贺淑梅.胸腔活动性出血的观察.局解手术学杂志,2004,13(5):294-297.
[13]Kavi KS,Gall NP.Trauma and syncope: looking beyond the injury.Trauma Surg Acute Care Open,2023,8(1):e001036.
[14]张雪莲,张铁,刘宁,等.遥测心电监护诊断心源性晕厥.临床心电学杂志,2017,26(3):178-181.
[15]周海英,张玉侠,陈潇,等.肝癌患者术后恶心呕吐发生现况及影响因素研究.中华护理杂志,2022,57(2):182-187.
[16]Brignole M,Moya A,de Lange FJ,et al.2018 ESC Guidelines for the diagnosis and management of syncope.Eur Heart J,2018,39(21):1883-1948.

备注/Memo

备注/Memo:
*通讯作者，Email：lianglbh@126.com
更新日期/Last Update: 2023-08-10