全肺切除术后低氧血症危险因素分析与护理对策

Analysis of risk factors for hypoxemia after pneumonectomy and its nursing strategies

目的 探讨全肺切除术后低氧血症危险因素及护理对策。方法 回顾性分析2015年9月至2018年8月实施全肺切除术50例患者临床资料,根据血气分析结果,发生低氧血症21例,非低氧血症29例,分析导致全肺切除术后低氧血症的危险因素,提出相应的护理措施。结果 单因素分析结果表明,患者年龄≥65岁、术前心电图异常、麻醉时间≥4h、吸烟、术后白蛋白<34g/L是低氧血症发生的危险因素(P<0.05);多因素logistic回归分析结果表明,年龄≥65岁、麻醉时间≥4h是全肺切除术后发生低氧血症独立影响因素(P<0.05)。结论 年龄≥65岁、麻醉时间≥4h的全肺切除术患者术后低氧血症的发生率明显增加,护理人员应加强对高龄与麻醉时间过长患者的监护,及时采取相应的护理措施。

Objective To explore the risk factors for hypoxemia after pneumonectomy and its nursing strategies.Methods:To analyze the clinical data of 50 patients undergoing pneumonectomy from September 2015 to August 2018 retrospectively. According to the results of blood gas analysis, a total of 21 cases had hypoxemia and 29 cases didn't have hypoxemias. We analyzed the risk factors for hypoxemia after pneumonectomy, and proposed corresponding nursing measures. Results Univariate analysis showed that patients with age≥65 years, preoperative electrocardiogram abnormalities, anesthesia time≥4 hours, smoking, and postoperative albumin<34 g/L were risk factors for hypoxemia( P <0.05). The results of multivariate logistic regression analysis showed that age≥65 years and anesthesia time≥4 hours were the independent factors influencing hypoxemia after pneumonectomy( P <0.05). Conclusion The incidence of postoperative hypoxemia in patients undergoing pneumonectomy with age≥65 years and anesthesia time≥4 hours increases significantly. Nursing staff should strengthen the monitoring of patients with advanced age and excessive time of anesthesia, and take appropriate nursing measures in time.