CAJ | 학술논문

目的探讨下肢动脉硬化闭塞症围手术期死亡原因及影响因素,降低其围手术期死亡率.方法回顾性分析2005年7月至2010年7月15例下肢动脉硬化闭塞症围手术期死亡的临床资料.结果本组15例围手术期死亡患者中,术前死亡9例,包括多器官功能衰竭5例、心功能衰竭2例、心源性猝死和呼吸衰竭各1例;术后死亡6例,包括急性肾功能衰竭2例、心功能衰竭2例、脑梗死和失血性休克各1例.与心脏、肾脏及肺脏相关的死亡分别是10例、6例、2例;直接死于心功能衰竭、心源性猝死、肾功能衰竭、呼吸衰竭、脑梗死和失血性休克分别是4例、1例、2例、1例、1例、1例.多器官功能衰竭、心功能衰竭、急性肾功能衰竭是围手术期死亡的主要原因,共占73.33％(11/15).围手术期总病死率是3.11％ (15/483),手术死亡率是1.47％( 6/407).结论死亡原因与影响因素、器官功能密切相关,有效干预影响因素,加强围手术期器官功能的监测与治疗,有利于降低围手术期死亡率.
목적 탐토하지동맥경화폐새증위수술기사망원인급영향인소,강저기위수술기사망솔.방법 회고성분석2005년7월지2010년7월15례하지동맥경화폐새증위수술기사망적림상자료.결과 본조15례위수술기사망환자중,술전사망9례,포괄다기관공능쇠갈5례、심공능쇠갈2례、심원성졸사화호흡쇠갈각1례;술후사망6례,포괄급성신공능쇠갈2례、심공능쇠갈2례、뇌경사화실혈성휴극각1례.여심장、신장급폐장상관적사망분별시10례、6례、2례;직접사우심공능쇠갈、심원성졸사、신공능쇠갈、호흡쇠갈、뇌경사화실혈성휴극분별시4례、1례、2례、1례、1례、1례.다기관공능쇠갈、심공능쇠갈、급성신공능쇠갈시위수술기사망적주요원인,공점73.33％(11/15).위수술기총병사솔시3.11％ (15/483),수술사망솔시1.47％( 6/407).결론 사망원인여영향인소、기관공능밀절상관,유효간예영향인소,가강위수술기기관공능적감측여치료,유리우강저위수술기사망솔.
Objective To investigate the causes of death and the influencing factors in patients with peripheral arterial disease(PAD) during the perioperative period and reduce the perioperative mortality.Methods A retrospective analysis of the causes of death was performed for PAD during the perioperative period in our hospital from July 2005 to July 2010. Results Nine patients died preoperatively.The causes of death were multible organ failure in 5,heart failure in 2,sudden cardiac death in 1,and respiratory failure in 1.Six patients died postoperatively.The causes of death were acute renal failure in 2,heart failure in 2,cerebral infarction in 1,and hemorrhagic shock in 1.The causes of death which were related to heart,kidney and lung were in 10,6 and 2,respectively.The causes of death which were directly due to heart failure,sudden cardiac death,renal failure,respiratory failure,cerebral infarction and hemorrhagic shock were in 4,1,2,1,1 and 1,respectively.The main causes of death were multible organ failure,heart failure and acute renal failure,which accounted for 73.33％ of all deaths.In this series the overall perioperative mortality was 3.11％ (15/483),Operative mortality was 1.47％ (6/407).Conclusions The influencing factors and the function of organs were closely correlated with the causes of death. To reduce the perioperative mortality of PAD,it is necessary both to intervene in the influencing factors and to monitor and treat the dysfunction of vital organs.