ACUTE EXACERBATION OF IDIOPATHIC INTERSTITIAL PNEUMONIA AFTER NONPULMONARY SURGERY UNDER GENERAL ANESTHESIA: A RETROSPECTIVE STUDY
ACUTE EXACERBATION OF IDIOPATHIC INTERSTITIAL PNEUMONIA AFTER NONPULMONARY SURGERY UNDER GENERAL ANESTHESIA: A RETROSPECTIVE STUDY
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DOI：
10.36141/svdld.v34i2.5366
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发表时间：
2017-01-01
影响因子：
1.6
通讯作者：
Homma, Sakae
中科院分区：
文献类型：
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作者：
Furuya, Kenta;Sakamoto, Susumu;Homma, Sakae
背景：特发性间质性肺炎(IIP)与肺手术后急性加重的风险增加有关，预后较差，可致命。虽然一些研究已经研究了肺手术后IIP的急性加重，但非肺手术后IIP急性加重的发生率和风险尚未见报道。本研究的目的是评估非肺手术后IIP急性加重的特点和危险因素。方法：我们回顾了2008年4月至2013年4月在全麻下接受非肺手术的2908例患者(男性1620例，女性1288例；平均年龄61.7岁)。使用术前胸部计算机断层扫描图像，我们确定了IIP病例，并比较了发生和未发生AE的患者的术前特征、实验室结果和麻醉条件。结果：我们抽取了103例接受非肺手术的IIP患者，其中8例(7.8%)术后发生IIP急性加重。单因素分析确定了几个危险因素，即急诊手术、术前使用强的松龙、高血清C反应蛋白、乳酸脱氢酶、白细胞计数、低血清白蛋白和麻醉期间使用异丙酚。结论：非肺手术和肺手术后IIP急性加重的发生率相似。此外，麻醉期间异丙酚的使用可能是非肺手术后IIP急性加重的危险因素。
Background: Idiopathic interstitial pneumonia (IIP) is associated with increased risk of acute exacerbation after lung surgery, which has a poor prognosis and can be fatal. Although some studies have investigated acute exacerbation of IIP after lung surgery, the incidence and risks of acute exacerbation of IIP after non-pulmonary surgery have not been reported. The aim of present study to evaluate the characteristics and risk factors for acute exacerbation of IIP after nonpulmonary surgery. Methods: We retrospectively reviewed the clinical characteristics of 2908 consecutive patients (1620 men, 1288 women; mean age, 61.7) who underwent nonpulmonary surgery under general anesthesia between April 2008 to April 2013. Using preoperative chest computed tomography images, we identified IIP cases and compared preoperative characteristics, laboratory findings, and anesthesia conditions among patients who did and did not develop AE. Results: We extracted 103 IIP patients who underwent nonpulmonary surgery; postoperative acute exacerbation of IIP developed in 8 (7.8%). Univariate analysis identified several risk factors, namely, emergency surgery, preoperative prednisolone use, high serum C-reactive protein, lactate dehydrogenase, white blood cell count, low serum albumin and propofol use during anesthesia. Conclusion: The results suggest that the incidences of postoperative acute exacerbation of IIP are similar after nonpulmonary and pulmonary surgery. In addition, propofol use during anesthesia is a possible risk factor for acute exacerbation of IIP after nonpulmonary surgery.