影响术后呼吸衰竭预后的相关因素分析

Related risk factors for postoperative respiratory failure

目的:观察影响外科术后呼吸衰竭(PORF)预后的危险因素,分析临床治疗方法,以期提高外科手术治疗效果和降低病死率。方法:回顾性分析我院SICU2004-2008年收治的84例PORF患者的临床资料,对影响PORF预后的危险因素进行Logistic回归分析。结果:Ⅰ型呼吸衰竭40例,Ⅱ型呼吸衰竭44例。死亡49例,病死率为58.3%。死亡组在年龄、慢性阻塞性肺疾病(COPD)、冠心病史、脏器功能障碍及APACHEⅡ评分方面与存活组比较差异有显著性(P<0.05)。多因素回归分析显示,高龄、COPD、脏器功能障碍及高APACHEⅡ评分是外科PORF死亡的危险因素。结论:高龄、高APACHEⅡ评分、COPD和术后脏器功能障碍是外科PORF死亡主要危险因素。

Objective To observe the risk factors that influence patient′s outcome with postoperative respiratory failure（PORF）, and to analyze related treatment method, improve the prognosis of surgical treatment and decrease the mortality of surgical patients.Methods Eighty-four patients with PORF were retrospectively analyzed from 2004 to 2008 administering in surgical intensive care unit（SICU）.The correlation between risk factors and the patients′ survival was analyzed.Results Among the total patients of the research, forty cases of type Ⅰ respiratory failure and forty-four cases of type Ⅱ respiratory failure were enrolled.Among the total cases, forty-nine cases died, the mortality was 58.3%.There were significant difference in age, record of chronic obstructive pulmonary disease（COPD）, coronary artery disease, organ functional disturbance and APACHEⅡ score between the death and the survival（P 0.05）.The multiple Logistic analysis demonstrated that the factors which significantly related to the prognosis of PORF were advanced age, history of COPD, higher APACHEⅡ score and postoperative organ functional disturbance.Conclusion Advanced age, history of COPD, higher APACHEⅡ score and postoperative organ functional disturbance are main risk factors of PORF.