胃肠手术后肺部并发症228例临床分析

A Clinical Analysis of Pulmonary Complication in 228 Patients Undergoing Gastrointestinal Surgery

目的 探讨胃肠手术患者术后发生肺部并发症的易患因素。 方法 回顾性分析 2 2 8例胃肠手术后肺部并发症患者 (并发症组 )的有关临床资料 ,以同期 774例胃肠手术后无肺部并发症作为对照 (对照组 )。 结果 并发症组患者平均年龄、有吸烟史和基础心肺疾病者所占的比例、血清尿素氮和肌酐水平、术中出血和输血量、术中气管插管时间、术后留置胃管和机械通气时间均显著高于对照组 ;并发症组血清白蛋白水平显著低于对照组。 结论 高龄、有吸烟史和基础心肺疾病、血清白蛋白水平低于正常、术中出血量多、气管插管时间长、术后留置胃管及机械通气时间长的胃肠手术患者易发生肺部并发症。

Objective To identify the risk factors for postoperative pulmonary complications (PPC) in patients undergoing gastrointestinal surgery. Methods 228 cases undergoing gastrointestinal surgery with PPC (PPC group) were retrospectively studied and compared with 774 cases undergoing gastrointestinal surgery without PPC (control group) in the same period. Results Compared with the control group, 10 parametres were significantly increased in the PPC group, including average age,proportion of patients with history of smoking, proportion of patients with cardiac and respiratory diseases, BUN and creatinine, volume of blood loss and transfusion during operation, duration of intraoperative intratracheal intubation, duration of postoperative nasogastric intubation and duration of postoperative mechanical ventilation. The concentration of serum albumin was significantly lower in the PPC group than in the control group. Conclusions The risk of PPC was significantly increased for patients with old age, history of smoking,history of cardiac and respiratory diseases, lower serum albumin, excessive blood loss during operation, long duration of intraoperative intratracheal intubation, long duration of postoperative nasogastric intubation and postoperative mechanical ventilation.