普通外科老年患者术后早期低氧血症与感染的临床分析

Clinical analysis of early postoperative hypoxemia and infections in elderly patients

目的探讨普通外科老年患者术后早期低氧血症及术后感染的危险因素,并制定对应的预防方法,降低患者低氧血症及感染的发生率。方法选取2010年7月-2013年8月收治的普通外科老年手术患者55例,根据患者术后发生低氧血症为A组23例和未发生低氧血症为B组32例,对两组病例进行单因素分析筛选出相关的危险因素后,再采用logistic多元回归分析进行多因素的分析。结果 55例普通外科老年患者术后发生早期低氧血症共23例,发生率为41.8%,男性发病率高于女性,logistic多元回归分析的结果显示,性别、吸烟史、糖尿病、高脂血症、术前肺功能异常以及手术时间是其独立危险因素;55例患者中术后发生感染5例,感染率为9.1%。结论老年普通外科术后早期低氧血症与否与性别、高脂血症、吸烟史、术前肺功能异常以及手术时间有密切联系,术后感染与糖尿病、术前肺功能、手术时机、住院时间、手术时间有关,对这些危险因素应积极预防和早期干预,减少低氧血症发生率和感染率。

OBJECTIVE To investigate the risk factors for early hypoxemia and infections in elderly patients after surgery,and to develop the corresponding methods of prevention,and reduce the incidence of hypoxemia and infections.METHODS Totally 55 elderly surgical patients admitted in Jul.2010 to Aug.2013 were enrolled and divided into group A（23cases with postoperative hypoxemia）and group B（32cases without postoperative hypoxemia）.The univariate analysis was used to screen the related risk factors,then the logisticregression analysis was used to analyze multiple factors.RESULTS There were a total of 23 cases with early onset of postoperative hypoxemia in the 55 elderly patients,the incidence rate was 41.8%,higher in males than in females.The logistic regression showed that gender,smoking history,diabetes,hyperlipidemia,abnormal lung function before surgery,and operative time were independent risk factors.Five out of 55 patients had postoperative infections,the infection rate was 9.1%.CONCLUSION Early postoperative hypoxemia in elderly patients was closely related to gender,hyperlipidemia,smoking history,preoperative abnormal pulmonary function,and operative time,postoperative infection was related to diabetes,preoperative pulmonary function,timing of surgery,hospital stay,and operative time.Active prevention and early intervention should be adopted targeting at these risk factors so as to reduce the incidence and prevalence of hypoxemia and infections.