孤立性肺结节153例研究.doc

孤立性肺结节153例研究[摘要] 目的：探讨孤立性肺结节为恶性结节的危险因素。方法：统计153例孤立性肺结节的临床特征，对这些临床特征与孤立性肺结节的性质之间的关系作单因素分析，进一步对有统计学意义者作多因素分析。结果：153例中有86例（56.21%）术后病检结果为恶性病变，单因素分析中，年龄、吸烟史及恶性肿瘤影像学特征3个因素具有统计学意义，多因素分析中年龄、恶性肿瘤影像学特征两个因素具有统计学意义。结论：年龄、吸烟史及恶性肿瘤影像学特征，尤其是前二者是孤立性肺结节为恶性结节的危险因素，综合分析这些因素，可提高对孤立性肺结节良恶性判断的准确性。 [关键词] 孤立性肺结节；危险因素 [中图分类号] R734.2 [文献标识码]A[文章编号]1673-7210（2008）01（a）-043-02 The analysis of 153 cases with solitary pulmonary nodule LU Yong-guo, WAN Zhi-yu (Department of Thoracic Surgery, Guangyuan Central Hospital,Guangyuan 628000, China) [Abstract] Objective:To investigate the risk factor of solitary pulmonary nodule(SPN), which was possibly m alignant tumor.Methods:Had a monovariate analysis on the correlation between clinical characteristic and pathological characteristic in 153 cases with SPN, and then had a multivariate analysis in the factors with significant difference.Results:Eighty-six cases postoperatively proved to be m alignant tumor. There was significant correlation between three factors(namely age,smoking and image characteristic) and pathological characteristic in monovariate analysis. However only two factors -age and image characteristic - were left in multivariate analysis.Conclusion:Age, smoking and image characteristic, especially to age andsmoking, are the risk factors of SPN. With a overall analysis over these factors, doctors can improve diagnosis accuracy on SPN. [Key words] Solitary pulmonary nodule(SPN);Risk factor. 现将153例孤立性肺结节的诊治体会报道如下： 1 资料与方法 1.1 一般资料 本组153例患者，其中，男94例，女59例。年龄29～71（57.8±9.8）岁。吸烟者102例，不吸烟者51例。伴有咳嗽、痰中带血及胸痛等症状者78例，不伴症状者75例。病变位于左肺上叶42例，左肺下叶19例；右肺上叶45例，右肺中叶12例，右肺下叶35例；双肺上叶75例，双肺中叶(左侧为舌叶)24例，双肺下叶54例；左肺61例，右肺92例。具有分叶征、毛刺征及胸膜凹陷征等恶性肿瘤影像学征象者68例，不具有这些征象者85例。结节直径小于1.5 cm者62例，大于1.5 cm者91例。 1.2 方法 统计153例患者的性别、年龄、吸烟史、症状、病变部位、影像学特征及肺部结节的大小等资料，并对这些临床因素与病变良恶性间的关系作单因素分析，将单因素分析有统计学意义的因素代入Logistic regression作多因素分析。年龄分段以常用的青年肺癌与中老肺癌的年龄界限40岁为界，左肺上叶分为上支和舌支，舌支（也称舌叶）从解剖结构来看，与右肺中相似，本文将其与右肺中叶一起称双肺中叶。 1.3 统计学处理 计数资料用χ2检验，用Logisti