老年胃癌术后肺部并发症危险因素分析

Risk factors of postoperative pulmonary complications after gastric cancer surgery in aged patients

目的探讨老年胃癌术后肺部并发症的相关危险因素。方法回顾性分析2005年1月至2013年8月195例70岁以上老年胃癌手术患者的术后肺部并发症发生的情况,采用SPSS13.0统计软件,组间计数资料比较用χ2检验,以P﹤0.05为差异有显著性。结果 195例老年胃癌手术患者,出现术后肺部并发症50例,发病率为25.64%(50/195)。患者年龄大于80岁、体重指数>25、有吸烟史、慢性阻塞性肺气肿史、低蛋白血症、糖尿病史等术前状况因素与术后的肺部并发症发生有关,差异均有统计学意义(χ2=5.63、6.28、7.32、8.62、6.56、6.95,P﹤0.05)。手术方式包括近端胃切除术、全胃切除术、联合脾切除术及全麻插管时间超过3 h等因素与术后的肺部并发症发生有关,差异均有统计学意义,(χ2=8.26、8.52、8.67、9.12,P﹤0.05)。结论术后肺部并发症的发生与高龄、肥胖、吸烟、慢性阻塞性肺气肿史、低蛋白血症、糖尿病、手术方式有明显关系,是主要的危险因素。

Obsjective To investigate the risk factors of postoperative pulmonary complications （PPC） after gastric cancer surgery in aged patients . Methods From January 2005 to August 2013, risk factors of postoperative pulmonary complications in （above 70 year old） 195 aged patients with gastric cancer were analyzed retrospectively .By using SPSS13.0 software, count data were analyzed by the chi-square test. AP value ﹤0.05 was considered statistically significant . Results In 50 of 195 aged patients, the incidence rate of PPC was 25.64%（50/195）.The incidence rate of PPC was significantly increased in patients aged over 80, with BMI ＆gt;25, history of smoking or chronic obstructive pulmonarydisease （COPD）, hypoproteinemia, diabetes mellitus （χ2 =5.63, 6.28, 7.32, 8.62, 6.56, 6.95 respectively, P﹤0.05）.PPC was significantly increased in patients , who received proximal gastrectomy , total gastrectomy and combined splenectomy and endotracheal intubation time over 3 hours （χ2 =8.26, 8.52, 8.67, 9.12 respectively, P ﹤0.05）. Conclusion Major risk factors of PPC include old age, fat, smoking history, chronic obstructive pulmonarydisease （COPD）, hypoproteinemia, diabetes mellitus, and surgical patterns .