贲门癌患者术后呼吸功能衰竭的高危因素研究

Risk Factors of Postoperative Respiratory Failure in Patients with Carcinoma of Gastric Cardia

目的探讨贲门癌患者术后发生呼吸功能衰竭的高危因素。方法应用χ2检验及二分类Logistic回归分析等统计学方法,对61例术后发生呼吸功能衰竭的贲门癌患者的高危因素进行分析。结果单因素分析结果显示:年龄、术前合并慢性阻塞性肺疾病(COPD)、肺功能〔肺活量(VC)、用力肺活量(FVC)、第1秒用力呼气容积(FEV1)〕、麻醉气管插管、手术持续时间及术中液体输入量对贲门癌患者术后呼吸功能衰竭发生的影响有统计学意义(P<0.05)。Logistic回归分析结果显示,术前中度及重度肺功能障碍、高龄、术中麻醉单腔气管插管及术中过多液体输入量对贲门癌患者术后呼吸功能衰竭发生的影响有统计学意义,OR值分别为24.892(P=0.000)、14.722(P=0.000)、7.336(P=0.000)、5.786(P=0.009)和4.571(P=0.003)。结论术前中重度肺功能障碍、高龄、术中麻醉单腔气管插管和术中过多液体输入量是贲门癌患者术后发生呼吸功能衰竭的高危因素。

Objective To investigate the risk factors of postoperative respiratory failure in patients with carcinoma of gastric cardia(CGC).Methods The risk factors of post-operative respiratory failure were analyzed in 61 CGC patients using chi square test and multivariable Logistic regression analysis.Results Univariate analysis showed that age,comorbidity with chronic obstructive pulmonary disease(COPD),poor pulmonary function,use of endobronchial tube during anesthesia,operation duration,and intraoperative fluid input were significantly associated with incidence of postoperative respiratory failure.Multivariate logistic regression analysis indicated that severe(OR=24.892,P=0.000) and moderate(OR=14.722,P=0.000) preoperative pulmonary function,old age(OR=7.336,P=0.000),use of single-lumen endobronchial tube during anaesthesia(OR=5.786,P=0.009),and excessive intraoperative fluid input(OR=4.571,P=0.003) were significantly associated with incidence of postoperative respiratory failure.Conclusion Poor preoperative pulmonary function,old age,use of single-lumen endobronchial tube during anaethesia,and excessive intraoperative fluid input are the risk factors of postoperative respiratory failure in CGC patients.