食管癌患者切除术后并发急性呼吸衰竭的危险因素

Risk Factors of Acute Respiratory Failure After Resection of Esophageal Cancer

目的 分析食管癌(EC)患者术后并发急性呼吸衰竭(ARF)的危险因素。方法 将EC术后并发ARF的患者62例作为ARF组,并以1∶1配比选取同期EC术后未并发ARF的患者62例作为无ARF组。采用自制调查表对2组性别、年龄、吸烟史、合并症、手术时间、肿瘤分期等资料进行收集,分析EC患者术后并发ARF的影响因素。结果 单因素分析显示,合并慢阻肺、肺气肿、手术切口数目、手术操作时长、吻合部位、术后严重并发症是影响EC患者术后并发ARF的因素(P<0.05);Logistic回归分析显示,合并慢阻肺、肺气肿、手术切口数目>2个、手术操作时长>4 h、吻合部位在胸部、术后有严重并发症是EC患者术后并发ARF的独立危险因素(P<0.05)。结论 EC患者术后并发ARF的影响因素较多,临床需根据相关危险因素采取针对性干预措施,降低术后ARF发生风险,改善预后。

Objective To analyze the risk factors of postoperative acute respiratory failure(ARF) in patients with esophageal cancer(EC).Methods 62 patients with ARF after EC operation were selected as ARF group, and 62 patients without ARF after EC operation were selected as non ARF group in 1:1 ratio.The data of sex, age, smoking history, comorbidities, operation time, tumor stage, etc.of the 2 groups were collected by using self-made questionnaire to analyze the influencing factors of postoperative ARF in EC patients.Results Single factor analysis showed that chronic obstructive pulmonary disease(COPD),emphysema, the number of surgical incisions, the length of operation, the site of anastomosis, and serious postoperative complications were the single factors influencing the postoperative ARF in EC patients(P<0.05);logistic regression analysis showed that patients with chronic obstructive pulmonary disease(COPD),emphysema, number of surgical incisions>2,operation time>4 hours, anastomotic site in the chest, and severe postoperative complications were the independent risk factors for postoperative ARF in EC patients(P<0.05).Conclusion There are many influencing factors for postoperative ARF in patients with EC,and clinical intervention measures should be taken according to relevant risk factors to reduce the risk of postoperative ARF and improve the prognosis.