实用医学杂志2025，Vol.41Issue(5)：724-730,7.DOI:10.3969/j.issn.1006-5725.2025.05.016
术中使用地塞米松对非小细胞肺癌患者术后长期生存的影响
Association between intraoperative dexamethasone and long-term survival in non-small cell lung cancer patients undergoing curative resection
摘要
Abstract
Objective To investigate the association between intraoperative dexamethasone administration and long-term survival outcomes.Methods A total of 1 629 NSCLC patients who underwent lung tumor resection between January 2008 and December 2014 were included in this study.A propensity score-matched cohort was generated at a ratio of 1∶2 to compare patients who received dexamethasone with those who did not.This matching process resulted in a cohort of 532 patients in the non-DEX group and 283 patients in the DEX group.Within this propensity score-matched cohort,disease-free survival(DFS)and overall survival(OS)were compared between the non-DEX and DEX groups using the Kaplan-Meier method.Additionally,Cox proportional hazards regression analysis was used to evaluate the associations between intraoperative administration of dexamethasone and high-risk factors for postoperative nausea and vomiting(PONV),as well as their impact on DFS and OS.Results After propensity score matching,intraoperative dexamethasone was significantly associated with worse OS(P=0.005),while no significant correlation was observed between intraoperative dexamethasone and DFS.Multivariate Cox regression analyses indicated that intraoperative dexamethasone was associated with poorer overall survival(HR=1.233,95%CI:1.002～1.516,P=0.048).In subgroup analyses,intraoperative dexamethasone was significantly associated with shorter OS in the female,video-assisted thoracoscopic surgery(VATS),prolonged anesthetic time,and inhalation anesthesia subgroups.Conclusions There was a significant correlation between intraopera-tive dexamethasone administration and overall survival in NSCLC patients following curative surgery.In high-risk subgroups for PONV,including females,those undergoing VATS,patients with prolonged anesthetic duration,and those under inhalation anesthesia,the administration of intraoperative dexamethasone was associated with a potentially poorer prognosis compared to patients who did not receive intraoperative dexamethasone.关键词
术中/地塞米松/非小细胞肺癌/生存时间/倾向性评分匹配Key words
intraoperative/dexamethasone/non-small cell lung cancer/survival/propensity-score matching分类
医药卫生引用本文复制引用
黄洋,屈舸,王培宗,曾维安,闫芳..术中使用地塞米松对非小细胞肺癌患者术后长期生存的影响[J].实用医学杂志,2025,41(5):724-730,7.基金项目
国家自然科学基金面上项目(编号:82172843) （编号:82172843）
