普外科急诊患者术后并发症相关危险因素分析

Analysis of risk factors related to postoperative complications in emergency patients of general surgery

目的普外科急诊患者术后并发症发生率较高,通过对并发症发生情况的相关危险因素分析,为临床实施针对性干预提供参考。方法选取济宁市充州区人民医院收治的行手术干预的150例普外科急诊患者作为研究对象(样本选取时间:2020年1月-2023年7月),回顾性分析其临床资料,根据并发症发生情况将其分为对照组(无并发症,120例)与观察组(存在并发症,30例),分析两组患者术后并发症发生情况、引起并发症的影响因素及独立危险因素。结果①150例普外科急诊患者中发生术后并发症患者30例,同时出现两种以上并发症11例;②单因素分析结果显示,年龄60岁及以上、ASAIE级及以上、部分基础疾病、手术级别≥2级、低血压持续20min以上、术中心律紊乱为快速型、围术期低氧血症、围术期输入量高、围术期失血量多、围术期总入超量大、手术时间长的患者并发症发生率高于普通患者,组间差异显著(P<0.05);③多因素分析结果显示,年龄60岁及以上、ASAIIE级及以上、低血压持续20min以上、术中快速型心动过速、手术级别2级及以上等因素是普外科急诊患者术后出现并发症的独立危险因素。结论普外科急诊患者中年龄60岁及以上、ASAIIE级及以上、手术级别≥2级、低血压时长>20min、术中快速型心动过速等因素是术后发生并发症的独立危险因素,临床治疗时应引起重视,通过针对性医护干预,降低患者并发症发生概率,进而提高治疗效果。

Objective Emergency patients in general surgery have high postoperative complications,by analyzing the risk factors related to complications,provide reference for clinical intervention.Method 150 emergency surgical patients in the our hospital were selected as the research subjects form January 2020 and July 2023,retrospective clinical data,according to the occurrence of complications,they were divided into a control group(120 cases without complications)and an observation group(30 cases with complications),analyze the incidence of postoperative complications,influencing factors,and independent risk factors in two groups of patients.Result ①Among the 150 patients,30 cases experienced complications,and 11 cases experienced two or more types of complications simultaneously;②Single factor analysis,Age>60 years old,ASA grade≥IIIE,some underlying diseases,surgical grade≥2,duration of hypotension>20 minutes,disordered surgical center rate as rapid type,perioperative hypoxemia,high perioperative input volume,high perioperative blood loss,large perioperative total input volume,and long surgical time.Patients have a higher incidence of complications than ordinary patients,there was a significant difference between groups(P<0.05);③Multifactor analysis,Age>60 years old,ASA grade≥IIE,duration of hypotension>20 minutes,intraoperative tachycardia,and surgical grade≥2 are independent risk factors for complications.Conclusion Patients over 60 years old,ASA grade≥IIE,surgical grade≥2,hypotension duration>20 minutes,and intraoperative tachycardia are independent risk factors for postoperative complications.Clinical attention should he paid to targeted interventions to reduce the incidence of complications and improve treatment effectiveness.