胆石症手术病人术后肺部并发症的危险因素探讨

Risk factors for postoperative pulmonary complications after cholelithotomy

目的探讨胆石症手术病人发生术后肺部并发症(PPC)的危险因素。方法对544例因胆石症住院并接受剖腹(非腹腔镜)手术治疗的病例资料进行回顾性分析,采用单因素、多因素Logistic回归分析的方法筛选与发生PPC相关的危险因素。结果单因素分析得出24个因素与PPC的发生相关;多因素Logistic回归分析筛选出发生PPC的独立危险因素为:围手术期经呼吸道雾化吸入治疗(OR=5．906)、术后抑酸剂使用时间(OR=1．145)、手术时间(OR=1．011)、术前血清白蛋白水平(OR=0．689)、术后镇痛(OR=0．059)。得出Logistic回归预测方程为:P(1)=1／[1+e-(- 9．803+1．776×A+0．135×B+0．011×C-0．372×D-2．835×E)]。结论围手术期经呼吸道雾化吸入治疗、术前血清白蛋白水平、手术时间、术后抑酸剂使用时间、术后镇痛与否是胆石症手术病人发生PPC的独立危险因素。

Objective To investigate the risk factors for postoperative pulmonary comphcations （PPC） after cholelithotomy. Methods The clinical data of 544 patients undergoing cholelithotomy in our hospital were retrospectively analyzed. Risk factors for PPC were screened by both univariate and multivariate logistic regression analyses. Results Twenty-four factors correlated with PPC were selected by univariate analysis. Multivariate logistic regression analysis revealed that perioperative respiratory inhalation （OR= 5. 906）, duration of postoperative antacids therapy （OR= 1. 145）, surgical duration （OR=1. 011）, serum albumin level （OR=0. 689） and postoperative analgesia （OR=0. 059） were risk factors for PPC after cholelithotomy. Logistic regression model for predicting the risk factors for PPC was P（1）=1/[1＋e-（-9.803＋1.776×A＋0.135×B＋0.011×C-0.372×D-2.835×E）]. Conclusions Respiratory inhalation therapy, duration of postoperative antacids therapy, surgical duration, serum albumin level and postoperative analgesia are risk factors for PPC after cholelithotomy,