老年食管癌患者术后肺部并发症发生的危险因素分析

Analysis of risk factors for postoperative pulmonary complications in elderly patients with esophageal cancer

目的:探讨老年食管癌患者发生术后肺部并发症(PPC)的危险因素。方法:对我院2009年3月至2012年06月282例行食管癌根治术患者的临床资料进行回顾性分析,收集其术前、术中及术后相关资料与数据,统计各种PPC,进行Logistic回归分析。结果:患者PPC的发生率为26.2%(74/282),单因素Logistic回归分析筛选22个相关因素;多因素分析显示,年龄(OR=1.485)、吸烟(OR=1.546)、ASA评级(OR=2.258)、术前存在肺部疾病(OR=1.383)、术中气管插管时间(OR=1.210)、术后机械通气时间(OR=1.302)为发生PPC的独立危险因素。结论:高龄、大量吸烟、ASA高评级、术前伴存肺部疾病、长时间气管插管及机械通气使老年食管癌患者易发生PPC。

Objective： To investigate the risk factors for postoperative pulmonary complication（PPC） in elderly patients with esophageal cancer.Methods： Two hundred and eighty-two elderly patients after esophagectomy from March 2009 to June 2012 were retrospectively analyzed.Univariate and multivariate logistic regression analysis were used to examine the risk factors for PPCs.Results： The incidence of PPC was 26.2%（74 /282）.Twenty-two factors correlated with PPC were selected by univariate analysis.Multivariate logistic regression analysis indicated that age（OR = 1.485）,smoking（OR = 1.546）,grade of ASA（OR = 2.258）,history of respiratory disease（OR = 1.383）,intraoperative duration of tracheal cannula（OR = 1.210）,postoperative duration of mechanical ventilation（OR =1.939） were the independent risk factors for PPCs in elderly patients with esophageal cancer.Conclusion： The patients undergoing esophageal cancer surgery with advanced age,excessive smoking,high rank of ASA,history of respiratory disease,long intraoperative duration of tracheal cannula,long postoperative duration of mechanical ventilation prefer totend to have PPC.