CAJ | 학술논문

目的：探讨综合医院血管外科手术并发症的相关因素。方法通过北京协和医院血管外科组织的一项单中心、前瞻性研究，对2012年1至12月期间进行首次择期血管外科手术的826例患者术后并发症的相关因素进行研究。结果入组患者中男566例（68.5％），女260例（31.5％），年龄13～89岁。共38例（4.6％）患者发生术后并发症，包括住院期间2例（0.2％）死亡。χ2检验显示患者高血压、心脏疾病、脑血管病史、肾功不全与糖尿病和并发症显著相关（ P＜0.05）。美国麻醉医师协会（ ASA ）高分级组（ ASA 3、4级）的术后并发症显著高于ASA低分级组（ ASA 1、2级）（ RR＝2.579；95％CI：1.333～4.993；P＜0.01）。手术高分级组（手术3、4级）的术后并发症显著高于手术低分级组（手术1、2级）（RR＝4.268；95％CI：2.197～8.293；P＜0.01）。结论高血压、心脏疾病、脑血管病史、肾功能不全与糖尿病是血管外科手术并发症的显著相关因素，麻醉ASA高分级和手术高分级与发生血管外科手术并发症极显著相关。
목적：탐토종합의원혈관외과수술병발증적상관인소。방법통과북경협화의원혈관외과조직적일항단중심、전첨성연구，대2012년1지12월기간진행수차택기혈관외과수술적826례환자술후병발증적상관인소진행연구。결과입조환자중남566례（68.5％），녀260례（31.5％），년령13～89세。공38례（4.6％）환자발생술후병발증，포괄주원기간2례（0.2％）사망。χ2검험현시환자고혈압、심장질병、뇌혈관병사、신공불전여당뇨병화병발증현저상관（ P＜0.05）。미국마취의사협회（ ASA ）고분급조（ ASA 3、4급）적술후병발증현저고우ASA저분급조（ ASA 1、2급）（ RR＝2.579；95％CI：1.333～4.993；P＜0.01）。수술고분급조（수술3、4급）적술후병발증현저고우수술저분급조（수술1、2급）（RR＝4.268；95％CI：2.197～8.293；P＜0.01）。결론고혈압、심장질병、뇌혈관병사、신공능불전여당뇨병시혈관외과수술병발증적현저상관인소，마취ASA고분급화수술고분급여발생혈관외과수술병발증겁현저상관。
Objective To analysis the factors related to the complications of vascular surgeries in a general hospital.Methods A single-center and prospective study was organized from January , 2012 to December , 2012 in Peking Union Medical College Hospital.Patients who underwent selective primary vascular procedures were included in the study.Results Totally 826 consecutive cases who met the inclusive criteria were recruited , with 566 males ( 68.5%) and an average age of ( 59 ±14 ) ( 13 -89 ) years old.There were 38 patients (4.6%) suffering complications after the procedures , including 2 deaths (0.2%) during hospitalization.The complication rates were significantly higher in the patients with hypertension , cardiac disease , history of cerebral strokes , renal function insufficiency or diabetic mellitus (P<0.05).The complication rates were significantly higher in group with high grade of ASA (ASA class 3 and 4) or in group underwent high grade of vascular surgeries (Class 3 and 4) , comparing with group with low grade of ASA ( ASA class 1 and 2 ) ( relative risk ratio , RR=2.579;95%CI:1.333 -4.993; P<0.01), or with group underwent low grade of vascular surgeries (Class 1 and 2) (RR=4.268;95%CI:2.197-8.293;P<0.01).Conclusions Hypertension, cardiac disease, history of cerebral stroke , renal function insufficiency or diabetic mellitus are risk factors related to complications of vascular surgeries .The patients with high grade of ASA or underwent high grade of vascular surgeries may have significant higher risks of complications after the procedures .