中国危重病急救医学
中國危重病急救醫學
중국위중병급구의학
CHINESE CRITICAL CARE MEDICINE
2011年
10期
625-628
,共4页
食管癌手术%肺部并发症%危险因子
食管癌手術%肺部併髮癥%危險因子
식관암수술%폐부병발증%위험인자
Esophagectomy%Pulmonary complication%Risk factors
目的 分析食管癌术后需要机械通气支持患者肺部并发症的危险因素,以利于术前对高风险的患者制定个体化治疗方案.方法 回顾性分析本院2008年5月至2010年6月82例经手术治疗食管癌患者的临床资料,应用多因素Logistic回归分析方法鉴别食管癌术后肺部并发症的危险因素.结果 82例接受手术治疗的食管癌患者术后共有12例发生了肺部并发症,术后死亡1例.多因素Logistic回归分析显示,术后肺部并发症的独立预测因子有高龄[优势比(OR)=1.28,95%可信区间(95%CI)为1.05～1.62,P=0.03]、肺功能受损[1秒用力呼气容积(FEV1%)OR=1.20,95%CI为1.08～1.39,P=0.02]和较长的手术时间(OR=1.68,95 %CI 为1.37～2.11,P=0.003).结论 高龄和肺功能受损是食管癌术后肺部并发症的危险因素,术前应评估患者发生术后肺部并发症的风险.对于高风险的患者,可以从个体化的治疗方案中获益.
目的 分析食管癌術後需要機械通氣支持患者肺部併髮癥的危險因素,以利于術前對高風險的患者製定箇體化治療方案.方法 迴顧性分析本院2008年5月至2010年6月82例經手術治療食管癌患者的臨床資料,應用多因素Logistic迴歸分析方法鑒彆食管癌術後肺部併髮癥的危險因素.結果 82例接受手術治療的食管癌患者術後共有12例髮生瞭肺部併髮癥,術後死亡1例.多因素Logistic迴歸分析顯示,術後肺部併髮癥的獨立預測因子有高齡[優勢比(OR)=1.28,95%可信區間(95%CI)為1.05～1.62,P=0.03]、肺功能受損[1秒用力呼氣容積(FEV1%)OR=1.20,95%CI為1.08～1.39,P=0.02]和較長的手術時間(OR=1.68,95 %CI 為1.37～2.11,P=0.003).結論 高齡和肺功能受損是食管癌術後肺部併髮癥的危險因素,術前應評估患者髮生術後肺部併髮癥的風險.對于高風險的患者,可以從箇體化的治療方案中穫益.
목적 분석식관암술후수요궤계통기지지환자폐부병발증적위험인소,이리우술전대고풍험적환자제정개체화치료방안.방법 회고성분석본원2008년5월지2010년6월82례경수술치료식관암환자적림상자료,응용다인소Logistic회귀분석방법감별식관암술후폐부병발증적위험인소.결과 82례접수수술치료적식관암환자술후공유12례발생료폐부병발증,술후사망1례.다인소Logistic회귀분석현시,술후폐부병발증적독립예측인자유고령[우세비(OR)=1.28,95%가신구간(95%CI)위1.05～1.62,P=0.03]、폐공능수손[1초용력호기용적(FEV1%)OR=1.20,95%CI위1.08～1.39,P=0.02]화교장적수술시간(OR=1.68,95 %CI 위1.37～2.11,P=0.003).결론 고령화폐공능수손시식관암술후폐부병발증적위험인소,술전응평고환자발생술후폐부병발증적풍험.대우고풍험적환자,가이종개체화적치료방안중획익.
Objective To identify risk factors for post-surgical pulmonary complications in patients with mechanical ventilation for respiratory failure and pneumonia after esphagectomy in order to guide the development of individualized treatment-plan for high risk patients.Methods Clinical data from 82 patients received esophagectomy for cancer during May 2008 to June 2010 were analyzed retrospectively using Logistic regression for risk factors associated with the development of post-surgical pulmonary complication Results Post-surgical pulmonary complications was found in 12 0ut of the 82 patients studied,and it was the primarily death cause for one of them.Multivariate Logistic analysis identified advanced age [odds ratio (OR) ～ 1.28,95% confidence interval (95%CI) 1.05 - 1.62,P= 0.03l,impaired pulmonary function (forced expiratory volume in one second (FEVi) OR = 1.20,95%CI l.08 - 1.39,P = 0.02) and longer operation duration (OR = 1.68,95%CI l.37 - 2.11,P= 0.003) as risk factors.Conclusion Advanced age and impaired lung function may be significant risk factors for pulmonary complications after esophagectomy.It is helpful to evaluate the risk of such complications by referring to these indexes before the surgery,and design individualized treatment-plan for patients at high risk.
