关键词: 肺肿瘤, 肺叶切除术, 拔管延迟, 危险因素

Abstract:  Objective To determine independent predictors of delayed postoperative extubation in patients undergoing lung cancer surgery. Method Records were retrospectively reviewed for 706 lung cancer patients who underwent lung resection under general anesthesia at the Affiliated Tumor Hospital of Guangxi Medical University from October 2008 to October 2013.Data were extracted on general patient condition，preoperative examination results，intra-and postoperative management， and other relevant factors.Uncon-ditional logistic regression was used to identify whether any of these indicators predicted delayed postoperative extubation.Then we compared incidence of postoperative complications and hospitalization time in the patients who underwent delayed extubation（n=51） and those who did not （n=655）. Result The incidence of delayed extubation in 706 lung cancer patients was 7.2%.Postoperative complications occurred in 18 of 51 patients in the delayed extubation group（35.3%），while they occurred in only 102 of 655 patients in the normal extubation group（15.6%，P＜0.05）.Length of hospitalization was significantly longer in the delayed extubation group （17.5±6.2 days） than in the normal extubation group（14.1±7.3 days，P<0.05）.Unconditional logistic regression identified five of the 25 variables tested as independent risk factors for delayed extubation：age>60 years（OR=6.568，P<0.001），prolonged single-lung ventilation（OR=1.268，P=0.047）， male gender（OR=1.511，P=0.046），urinary flow<17 ml/h（OR=1.456，P=0.032），and reduced lung function（OR=1.579，P=0.033）. Conclusions Delayed postoperative extubation after lobectomy in lung cancer patients is associated with longer hospital stay and greater risk of postoperative complications. This delay is caused by multi-factor synergism，related mainly to poor preoperative lung function，older age，male gender，poor urinary function，prolonged single-lung ventilation and other relevant factors.

Key words: Lung neoplasm, Lobectomy, Delayed extubation, Risk factor