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中华肺部疾病杂志(电子版) ›› 2022, Vol. 15 ›› Issue (03) : 416 -418. doi: 10.3877/cma.j.issn.1674-6902.2022.03.035

短篇论著

早期肺癌胸腔镜术后切口愈合不良的危险因素分析
王婷1, 戴小霞1, 刘权兴2, 戴纪刚2, 余江1,()   
  1. 1. 400037 重庆,陆军(第三)军医大学第二附属医院门诊部
    2. 400037 重庆,陆军(第三)军医大学第二附属医院胸外科
  • 收稿日期:2021-09-19 出版日期:2022-06-25
  • 通信作者: 余江
  • 基金资助:
    重庆市科卫联合项目(2020MSXM031)

Analysis of risk factors for poor incision healing after thoracoscopy in early lung cancer

Ting Wang1, Xiaoxia Dai1, Quanxing Liu2   

  • Received:2021-09-19 Published:2022-06-25
引用本文:

王婷, 戴小霞, 刘权兴, 戴纪刚, 余江. 早期肺癌胸腔镜术后切口愈合不良的危险因素分析[J]. 中华肺部疾病杂志(电子版), 2022, 15(03): 416-418.

Ting Wang, Xiaoxia Dai, Quanxing Liu. Analysis of risk factors for poor incision healing after thoracoscopy in early lung cancer[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2022, 15(03): 416-418.

胸腔镜手术(video-assisted thoracoscopic surgery, VATS)是治疗早期肺癌的外科常用手术方式[1],具有创伤小、恢复快、应用范围广等优点[2],但随之而来的术后切口愈合不良(poor wound healing, PWH)是胸外科临床工作中不容忽视的问题[3]。VATS术后PWH的主要原因有:切口裂开渗液、脂肪液化、愈合延迟等[4]。VATS术后发生PWH将导致住院时间增加,且增加切口感染及肺部感染发生的风险[5]。早期识别可能发生PWH的高危人群,并及时做出预防性干预措施,对VATS术后降低感染风险有重要意义。分析VATS术后PWH的报道较少,本文回顾性分析了我院伤口治疗门诊处理的胸腔镜术后患者的临床资料,旨在分析胸腔镜手术后切口愈合不良的危险因素,报道如下。

表1 两组患者暴露因素的单因素分析
表2 PWH危险因素的Logestic回归分析
1
王 群,蒋 伟,王 琳,等.肺部磨玻璃结节的处理原则和共识及手术技巧[J]. 中华肿瘤杂志2019, 41(1): 6-9.
2
漏佳颖,吴佳丰,孙锡飞,等.胸腔镜手术对肺癌患者术后感染及疼痛应激相关指标的影响[J]. 浙江创伤外科2022, 27(1): 32-34.
3
周海清,王明雪,王春叶,等.胸腹腔引流管拔除后手术切口愈合不良风险预测模型构建[J]. 中华现代护理杂志2022, 28(1): 70-75.
4
Greer N, Foman NA, MacDonald R, et al. Advanced wound care therapies for nonhealing diabetic, venous, and arterial ulcers: a systematic review[J]. Ann Intern Med, 2013, 159(8): 532-542.
5
Chin JS, Madden L, Chew SY, et al. Drug therapies and delivery mechanisms to treat perturbed skin wound healing[J]. Adv Drug Deliv Rev, 149-150: 2-18.
6
Velnar T, Bailey T, Smrkolj V. The wound healing process: an overview of the cellular and molecular mechanisms[J]. J Int Med Res, 2009, 37(5): 1528-1542.
7
Rodrigues M, Kosaric N, Bonham CA, et al. Wound Healing: A Cellular Perspective[J]. Physiol Rev, 2019, 99(1): 665-706.
8
Davidoss NH, Eikelboom R, Friedland PL, et al. Wound healing after tonsillectomy-a review of the literature[J]. J Laryngol Otol, 2018, 132(9): 764-770.
9
Pradeep A, Rangasamy J, Varma PK. Recent developments in controlling sternal wound infection after cardiac surgery and measures to enhance sternal healing[J]. Med Res Rev, 2021, 41(2): 709-724.
10
Ng WS, Jayaram H. Adjunctive modulation of wound healing during cataract surgery to promote survival of a previous trabeculectomy[J]. Cochrane Database Syst Rev, 2021, 8(8): CD013664.
11
Eming SA, Martin P, Tomic-Canic M. Wound repair and regeneration:mechanisms, signaling, and translation[J]. Sci Transl Med, 2014, 6(265): 265sr6.
12
Moreira HR, Marques AP. Vascularization in skin wound healing: where do we stand and where do we go?[J]. Curr Opin Biotechnol, 2021, 73: 253-262.
13
Guo S, Dipietro LA. Factors affecting wound healing[J]. J Dent Res, 2010, 89(3): 219-229.
14
Mohamadi S, Norooznezhad AH, Mostafaei S, et al. A randomized controlled trial of effectiveness of platelet-rich plasma gel and regular dressing on wound healing time in pilonidal sinus surgery: Role of different affecting factors[J]. Biomed J, 2019 , 42(6): 403-410.
15
El-Ashram S, El-Samad LM, Basha AA, et al. Naturally-derived targeted therapy for wound healing: Beyond classical strategies[J]. Pharmacol Res, 2021, 170: 105749.
16
Qiu H, Liu S, Wu K, et al. Prospective application of exosomes derived from adipose-derived stem cells in skin wound healing: A review[J]. J Cosmet Dermatol, 2020 , 19(3): 574-581.
17
Zhu S, Yu Y, Ren Y, et al. The emerging roles of neutrophil extracellular traps in wound healing[J]. Cell Death Dis, 2021, 12(11): 984.
18
Petkovic M, Mouritzen MV, Mojsoska B, et al. Immunomodulatory properties of host defence peptides in skin wound healing[J]. Biomolecules, 2021, 11(7): 952.
19
Ezeani IU, Ugwu ET, Adeleye FO, et al. Determinants of wound healing in patients hospitalized for diabetic foot ulcer: results from the MEDFUN study[J]. Endocr Regul, 2020, 54(3): 207-216.
20
Charalambous C, Vassilopoulos A, Koulouri A, et al. The impact of stress on pressure ulcer wound healing process and on the psychophysiological environment of the individual suffering from them[J]. Med Arch, 2018, 72(5): 362-366.
21
Antonopoulos CN, Lazaris A, Venermo M, et al. Predictors of wound healing following revascularization for chronic limb-threatening ischemia[J]. Vasc Endovascular Surg, 2019 53(8): 649-657.
22
Yoshikawa H, Kujime S, Iwasaki M, et al. Poor survival of dialysis patients with unhealed wounds because of critical limb ischemia: Limb salvage and survival requires wound healing[J]. Int Wound J, 2019 , 16(5): 1112-1118.
23
Yanagiuchi T, Kato T, Hirano K, et al. Predictors of delayed wound healing after simultaneous endovascular treatment and minor forefoot amputation for chronic limb-threatening ischemia with wound infection[J]. Vascular, 2022, 17085381211067601.
24
Schlager JG, Hartmann D, Wallmichrath J, et al. Patient-dependent risk factors for wound infection after skin surgery: A systematic review and meta-analysis[J]. Int Wound J, 2022, Mar 1. doi: 10.1111/iwj.13780.
25
Rodriguez-Merchan EC. Surgical wound healing in bleeding disorders[J]. Haemophilia, 2012 , 18(4): 487-490.
26
Merrick D, Seale P. Skinny Fat Cells Stimulate Wound Healing[J]. Cell Stem Cell, 2020, 26(6): 801-803.
27
Casano AM, Sixt M. A fat lot of good for wound healing[J]. Dev Cell, 2018, 44(4): 405-406.
28
Ma J, Huang Z, Shen B, et al. Blood management of staged bilateral total knee arthroplasty in a single hospitalization period[J]. J Orthop Surg Res, 2014, 9: 116.
29
陈 磊,陈勇兵,吴雪杰,等.双根超细胸腔引流管在单孔胸腔镜肺部手术中的应用[J]. 中国肺癌杂志2021, 24(8): 577-582.
30
Gompelman M, van Asten SAV, Peters EJG. Update on the role of infection and biofilms in wound healing: Pathophysiology and treatment[J]. Plast Reconstr Surg, 2016138(3 Suppl): 61S-70S.
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