目的 探讨日间胸腔镜手术患者在出院后1个月内肺部并发症（PPCs）的发生率及其危险因素。 方法 选取2022年6-10月南京鼓楼医院集中式管理日间病房拟行择期电视辅助胸腔镜手术（VATS）患者200例，所有患者围术期实施加速康复外科（ERAS）管理。患者术后第1天晨由1名研究者在床旁行肺超声（LUS）检查。患者在出院后1月内至少在门诊完成1次X线或CT检查。根据影像学随访结果及患者复诊时临床症状主诉，明确是否发生PPCs，并将患者分为肺部并发症组（PPC+组）和正常组（PPC-组）。采用单因素分析VATS术后发生PPCs的相关影响因素，多因素logistic回归分析筛选独立危险因素。 结果 共有188例VATS患者接受了LUS检查并完成了1个月的随访，其中68例（36.1%）发生了不同种类的PPCs。多因素logistic回归分析显示，术前合并免疫系统疾病（OR = 24.36，95%CI：1.63 ~ 371.45，P = 0.021）、行肺叶切除术（OR = 1.01，95%CI：0.98 ~ 1.02，P = 0.031）和术后第1天LUSS高（OR = 1.37，95%CI：1.12 ~ 1.68，P = 0.002）是行日间VATS手术患者出院后1个月内发生PPCs的独立危险因素。 结论 合并免疫系统疾病、行肺叶切除术及术后第1天LUSS升高是日间VATS手术患者出院后1月内发生PPCs的独立危险因素。

Objective To determine risk factors of postoperative pulmonary complications within 1 month in patients undergoing thoracic surgery in Day Care Unit. Methods The total of 200 patients routinely scheduled for VATS under centralized management were enrolled in this study. On the postoperative day 1， lung ultrasound （LUS） was conducted by one physician in the ward. The patients received at least once Chest X?ray or CT in outpatient department within 30 days after discharge. The composite of out?of?hospital PPCs， and the value of LUSS in predicting the PPCs was appraised. Furthermore， we identified the perioperative risk factors associated with PPCs in VATS patients. Results Of 200 recruited VATS patients eligible in the Nanjing Drum Tower Hospital， 188 participants received LUS examination and finally completed the 30 days follow?up. Of whom， 68 patients developed the varied types of PPCs. Multivariable Logistic regression analysis indicated that comorbidity of immune system disease（P = 0.021）， lobar resection （P = 0.031） and the postoperative 24 hours LUSS （P = 0.002） were independent risk factors for PPCs within 30 days after VATS. Conclusion Comorbidity of immune system disease，lobar resection and the postoperative 24 h LUSS were independent risk factors for PPCs within 30 days after VATS。