CAJ | 학술논문

目的探讨食管癌术后肺部感染患者机械通气时间的影响因素。方法纳入术后肺部感染需气管插管或气管切开及机械通气患者55例，按机械通气时间＜7d为早期脱机组，≥7 d为晚期脱机组。同期食管癌术后肺部感染未行机械通气患者60例作为对照。比较术前、术中和术后因素对机械通气时间的影响。结果早期脱机患者、晚期脱机患者与对照组比较年龄更大(P＜0.05)，特别是晚期脱机患者年龄差异更明显（P＜0.01）。早期脱机患者与对照相比第一秒用力肺活量(FEV1)和最大通气量(MVV)显著下降(P＜0.05)。非发酵革兰阴性杆菌(NFGNB)感染率晚期脱机组较对照和早期脱机组显著增加（均P＜0.01）。Logistic回归多因素分析表明FEV1降低是早期脱机的独立影响因素(P＜0.01)，年龄(P＜0.05)和NFGNB感染（P＜0.01）影响晚期脱机。结论食道癌术后肺部感染者机械通气时间的主要影响因素有FEV1降低、年龄以及NFGNB感染等。
목적 탐토식관암술후폐부감염환자궤계통기시간적영향인소。방법 납입술후폐부감염수기관삽관혹기관절개급궤계통기환자55례，안궤계통기시간＜7d위조기탈궤조，≥7 d위만기탈궤조。동기식관암술후폐부감염미행궤계통기환자60례작위대조。비교술전、술중화술후인소대궤계통기시간적영향。결과 조기탈궤환자、만기탈궤환자여대조조비교년령경대(P＜0.05)，특별시만기탈궤환자년령차이경명현（P＜0.01）。조기탈궤환자여대조상비제일초용력폐활량(FEV1)화최대통기량(MVV)현저하강(P＜0.05)。비발효혁란음성간균(NFGNB)감염솔만기탈궤조교대조화조기탈궤조현저증가（균P＜0.01）。Logistic회귀다인소분석표명FEV1강저시조기탈궤적독립영향인소(P＜0.01)，년령(P＜0.05)화NFGNB감염（P＜0.01）영향만기탈궤。결론 식도암술후폐부감염자궤계통기시간적주요영향인소유FEV1강저、년령이급NFGNB감염등。
Objective To explore the influencing factors of mechanical ventilation time in esophageal cancer patients with lung infection after operation.Methods 55 esophageal cancer patients with lung infection after operation requiring endotracheal intubation or tracheostomy and mechanical ventilation were included.According to duration of mechanical ventilation time, ＜ 7 days for early weaned from ventilator group, ＞ 7 days for late weaning group.60 esophageal cancer patients with lung infection after operation without mechanical ventilation served as controls.Various factors on the impact of mechanical ventilation were compared.Results Early and late weaning patients were older than control group(P ＜ 0.05), particularly in late weaning patients(P ＜ 0.01).Compared with the control, FEV1 and MVV decreased significantly in early weaning patients(P ＜ 0.05).NFGNB infection in late weaning patients significantly increased than in early weaning patients and the control(all P ＜ 0.01).Logistic multivariate analysis showed that FEV1 was independent factors affecting early weaning (P ＜ 0.01), age (P ＜ 0.05) and NFGNB infection (P ＜0.01) affecting late weaning.Conclusion The influencing factors of mechanical ventilation time in esophageal cancer patiens with lung infection after operation were FEV1 decreasing,age and NFGNB infection.