Analysis of influencing factors for pulmonary infection after radical resection of colon cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YAN Jing ^1,2 ,  XIAO Kemin ² , HE Jinxing ²

1. Basic Medical College, Wuhan University, Wuhan 430000, P.R.China;
2. Department of General Surgery, People’s Hospital of Daye City, Daye, Hubei 435100, P.R.China;

Corresponding?author：

XIAO Kemin, Email: hsbxkm@163.com

Keywords：

pulmonary infection; radical resection of colon cancer; influencing factor

DOI：

10.7507/1007-9424.201611098

Video：

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Objective To explore the influencing factors for pulmonary infection after radical resection of colon cancer. Methods A cohort study included 56 patients who underwent radical resection of colon cancer in People’s Hospital of Daye City from Oct. 2014 to Oct. 2016 were followed-up prospectively, to observe the occurrence of pulmonary infection, and collectting the related factors for pulmonary infection in addition. Results The clinical data of 53 patients were finalized and the clinical data of these patients were complete. Among them, 13 patients suffered from pulmonary infection after radical resection of colon cancer, and 40 patients had no obvious exacerbation and no complicated pulmonary infection. Results of logistic regression showed that, value of forced expiratory volume in1 second/forced vital capacity (OR=1.174, P=0.033), operative time (OR=1.638, P=0.012), levels of postoperative copeptin (OR=1.328, P=0.032), and procalcitonin (OR=1.465, P=0.042) were risk factors for pulmonary infection after radical resection of colon cancer. Receiver operating characteristic curve (ROC) showed that, operative time was 6.207-hour, postoperative copeptin level was 10.420 pmol/L, and the postoperative procalcitonin level was 3.676 ng/mL, which had the best predictive effect on predicting pulmonary infection after radical resection of colon cancer. Conclusions Value of forced expiratory volume in 1 second/forced vital capacity, operative time, levels of copeptin and procalcitonin after operation are the independent influencing factors for pulmonary infection after radical resection of colon cancer, and it has best prognostic outcome when the operative time is 6.207-hour, postoperative copeptin level is 10.420 pmol/L, and the postoperative procalcitonin level is 3.676 ng/mL.

Citation： YAN Jing, XIAO Kemin, HE Jinxing. Analysis of influencing factors for pulmonary infection after radical resection of colon cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(8): 970-974. doi: 10.7507/1007-9424.201611098 Copy

1.	Nakano T, Araki K, Nakatani H, et al. Effects of geldanamycin and thalidomide on the Th1/Th2 cytokine balance in mice subjected to operative trauma. Surgery, 2007, 141(4): 490-500.
2.	張永波. 32 例結腸癌術后肺部感染病例的臨床分析. 中國醫藥導刊, 2004, 16(1): 29-31.
3.	Lee IK, Sung NY, Lee YS, et al. The survival rate and prognostic factors in 26 perforated colorectal cancer patients. Int J Colorectal Dis, 2007, 22(5): 467-473.
4.	劉曉瓏, 崔海燕, 劉立新, 等. 結腸癌術后肺部感染的免疫學因素分析. 山西醫藥雜志, 2010, 39(8): 707-709.
5.	楊紅暉, 姚小紅, 黃秀良. 全麻氣管插管術后患者肺部感染的調查分析. 中華醫院感染學雜志, 2009, 19(21): 2868-2869.
6.	華鋒, 王斌, 崔恩海. 和肽素對呼吸機相關性肺炎預后判斷的臨床意義. 中華醫院感染學雜志, 2013, 23(4): 743-745.
7.	付春毅, 溫偉, 張新超. 和肽素能否成為急危重癥的一個良好生物學標記物. 中國急救醫學, 2014, 34(11): 1044-1047.
8.	Watanabe T, Itabashi M, Shimada Y, et al. Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2010 for the treatment of colorectal cancer. Int J Clin Oncol, 2012, 17(1): 1-29.
9.	中國抗癌協會大腸癌專業委員會腹腔鏡外科學組, 中華醫學會外科分會腹腔鏡與內鏡外科學組. 腹腔鏡結腸直腸癌根治手術操作指南(2006版). 外科理論與實踐, 2006, 11(5): 462-464.
10.	華學洪, 李鳳鳴. 老年人全麻下上腹部手術后肺部感染的臨床分析. 瀘州醫學院學報, 2010, 33(2): 183-184.
11.	Biondo S, Kreisler E, Millan M, et al. Differences in patient postoperative and long-term outcomes between obstructive and perforated colonic cancer. Am J Surg, 2008, 195(4): 427-432.
12.	張素玲, 馬俊美. 老年患者實施開胸手術后合并肺部感染的危險因素分析. 安徽醫藥, 2015, 19(2): 355-357.
13.	于魯源, 陳素麗. 氣管插管全麻復合硬膜外麻醉對結腸癌患者術后肺部感染的影響. 現代消化及介入診療, 2016, 21(2): 287-289.
14.	楊永凱, 張帆, 薛少華, 等. 腦出血合并肺部感染患者血清降鈣素原、和肽素水平變化及其臨床意義. 重慶醫學, 2015, 44(34): 4802-4805.
15.	卞淼, 安蓮華, 張宏濤, 等. 血清合肽素對呼吸衰竭患者預后評估的臨床意義. 中國全科醫學, 2014, 17(4): 414-417.
16.	Du JM, Sang G, Jang CM, et al. Relationship between plasm copeptin levels and complications of community acquired pneumonia in preschool children. Peptides, 2013, 45(7): 61-65.
17.	楊永凱, 張帆, 薛少華, 等. 血清和肽素、降鈣素原對腦出血合并肺部感染早期診斷及判斷預后的價值. 重慶醫學, 2015, 44(18): 2483-2485.
18.	Salem TA, Molloy RG, O’Dwyer PJ. Prospective study on the role of C-reactive protein (CRP) in patients with an acute abdomen. Ann R Coll Surg Engl, 2007, 89(3): 233-237.
19.	李玉勤, 唐煒, 金勝利. 和肽素在小兒社區獲得性肺炎中的變化及意義. 廣東醫學, 2014, 35(24): 3855-3857.
20.	方明, 張琳, 王道標, 等. 急性肺損傷患者血清及肺泡灌洗液和肽素水平變化的臨床分析. 中華危重癥醫學雜志(電子版), 2011, 4(3): 155-161.
21.	魏益群, 孫鋼, 楊淑梅. 和肽素與降鈣素原聯合測定在膿毒血癥早期診斷及預后判斷的臨床意義. 中華醫院感染學雜志, 2011, 21(18): 3801-3803.
22.	Lee JH, Chan YH, Lai OF, et al. Vasopressin and copeptin levels in children with sepsis and septic shock. Intensive Care Med, 2013, 39(4): 747-753.
23.	閻萍, 張納新, 曾金潔, 等. 吸煙對慢性阻塞性肺疾病患者炎癥反應及和肽素水平的影響. 中國老年學雜志, 2016, 36(15): 3754-3756.
24.	Soontornniyomkij V, Lynch MD, Mermash S, et al. Cerebral micro infarcts associated with severe cerebral beta-amyloid angiopathy. Brain Pathol, 2010, 20(2): 459-467.

1. Nakano T, Araki K, Nakatani H, et al. Effects of geldanamycin and thalidomide on the Th1/Th2 cytokine balance in mice subjected to operative trauma. Surgery, 2007, 141(4): 490-500.
2. 張永波. 32 例結腸癌術后肺部感染病例的臨床分析. 中國醫藥導刊, 2004, 16(1): 29-31.
3. Lee IK, Sung NY, Lee YS, et al. The survival rate and prognostic factors in 26 perforated colorectal cancer patients. Int J Colorectal Dis, 2007, 22(5): 467-473.
4. 劉曉瓏, 崔海燕, 劉立新, 等. 結腸癌術后肺部感染的免疫學因素分析. 山西醫藥雜志, 2010, 39(8): 707-709.
5. 楊紅暉, 姚小紅, 黃秀良. 全麻氣管插管術后患者肺部感染的調查分析. 中華醫院感染學雜志, 2009, 19(21): 2868-2869.
6. 華鋒, 王斌, 崔恩海. 和肽素對呼吸機相關性肺炎預后判斷的臨床意義. 中華醫院感染學雜志, 2013, 23(4): 743-745.
7. 付春毅, 溫偉, 張新超. 和肽素能否成為急危重癥的一個良好生物學標記物. 中國急救醫學, 2014, 34(11): 1044-1047.
8. Watanabe T, Itabashi M, Shimada Y, et al. Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2010 for the treatment of colorectal cancer. Int J Clin Oncol, 2012, 17(1): 1-29.
9. 中國抗癌協會大腸癌專業委員會腹腔鏡外科學組, 中華醫學會外科分會腹腔鏡與內鏡外科學組. 腹腔鏡結腸直腸癌根治手術操作指南(2006版). 外科理論與實踐, 2006, 11(5): 462-464.
10. 華學洪, 李鳳鳴. 老年人全麻下上腹部手術后肺部感染的臨床分析. 瀘州醫學院學報, 2010, 33(2): 183-184.
11. Biondo S, Kreisler E, Millan M, et al. Differences in patient postoperative and long-term outcomes between obstructive and perforated colonic cancer. Am J Surg, 2008, 195(4): 427-432.
12. 張素玲, 馬俊美. 老年患者實施開胸手術后合并肺部感染的危險因素分析. 安徽醫藥, 2015, 19(2): 355-357.
13. 于魯源, 陳素麗. 氣管插管全麻復合硬膜外麻醉對結腸癌患者術后肺部感染的影響. 現代消化及介入診療, 2016, 21(2): 287-289.
14. 楊永凱, 張帆, 薛少華, 等. 腦出血合并肺部感染患者血清降鈣素原、和肽素水平變化及其臨床意義. 重慶醫學, 2015, 44(34): 4802-4805.
15. 卞淼, 安蓮華, 張宏濤, 等. 血清合肽素對呼吸衰竭患者預后評估的臨床意義. 中國全科醫學, 2014, 17(4): 414-417.
16. Du JM, Sang G, Jang CM, et al. Relationship between plasm copeptin levels and complications of community acquired pneumonia in preschool children. Peptides, 2013, 45(7): 61-65.
17. 楊永凱, 張帆, 薛少華, 等. 血清和肽素、降鈣素原對腦出血合并肺部感染早期診斷及判斷預后的價值. 重慶醫學, 2015, 44(18): 2483-2485.
18. Salem TA, Molloy RG, O’Dwyer PJ. Prospective study on the role of C-reactive protein (CRP) in patients with an acute abdomen. Ann R Coll Surg Engl, 2007, 89(3): 233-237.
19. 李玉勤, 唐煒, 金勝利. 和肽素在小兒社區獲得性肺炎中的變化及意義. 廣東醫學, 2014, 35(24): 3855-3857.
20. 方明, 張琳, 王道標, 等. 急性肺損傷患者血清及肺泡灌洗液和肽素水平變化的臨床分析. 中華危重癥醫學雜志(電子版), 2011, 4(3): 155-161.
21. 魏益群, 孫鋼, 楊淑梅. 和肽素與降鈣素原聯合測定在膿毒血癥早期診斷及預后判斷的臨床意義. 中華醫院感染學雜志, 2011, 21(18): 3801-3803.
22. Lee JH, Chan YH, Lai OF, et al. Vasopressin and copeptin levels in children with sepsis and septic shock. Intensive Care Med, 2013, 39(4): 747-753.
23. 閻萍, 張納新, 曾金潔, 等. 吸煙對慢性阻塞性肺疾病患者炎癥反應及和肽素水平的影響. 中國老年學雜志, 2016, 36(15): 3754-3756.
24. Soontornniyomkij V, Lynch MD, Mermash S, et al. Cerebral micro infarcts associated with severe cerebral beta-amyloid angiopathy. Brain Pathol, 2010, 20(2): 459-467.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis of influencing factors for pulmonary infection after radical resection of colon cancer

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