食管癌术后伴发呼吸系统并发症相关危险因素临床分析

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

摘要：目的探讨食管癌术后伴发呼吸系统并发症的相关危险因素，为防治提供参考。方法回顾性分析2011年1月～2013年3月该院胸外科收住的126食管癌患者的一般资料，其中21例术后伴发呼吸系统并发症，采用单因素及多因素分析方法对照分析相关危险因素。结果该研究126食管癌患者中，21例术后伴发呼吸系统并发症．发生率为（16．67％），其中肺炎14例、肺不张5例、呼吸窘迫综合征3例、肺栓塞1例、呼吸衰竭3例；术后伴发呼吸系统并发症的独立危险因素为：吸烟、肥胖、术前肺功能较差（FEV1％〈65％）、术中出血量〉500mL、手术时间〉4h及喉返神经损伤。结论食管癌术后易伴发呼吸系统并发症，术前戒烟、控制体重、改善肺功能，术中避免大量出血及避免喉返神经损伤可降低其发生率。

[Objective] To analyze the risk factors for postoperative pulmonary complications （PPCs） in patients with esophageal cancer. [ Methods ] 126 patients after esophagectomy were retrospectively analyzed during Jan 2011 to Mar 2013, all of them, 21 cases happened puhnonary complications. Univariate and multivariate logistic regression analysis was used to examine the risk factors for PPCs. [Results] In 126 patients PPCs occurred in 21 patients （16.67） including pneumonia in 14 cases, atelectasis in 5 eases, aduh respiratory distress syndrome （ARDS） in 3 eases, pulmonary embolism in lease and respiratory failure in 3 cases. Univariate and multivariate logistic regression analysis indicated that smoking, obesity, poor preoperative pulmonary function （FEVl〈65）, bleeding volmne over 500 mL during operation, operation time over 4h aml injure of recurrent laryngeal nerve were the independent risk fac- tors for PPCs in patients with esophageal cancer. [Conclusions] patients with esophageal cancer are easy to cause PPCs after operation, stop smoking, control body weight, ameliorate pulmonary timetion preoperative, avoid massive bleeding and injure of recurrent laryngeal nerve during operation can decrease incidence rate.