CAJ | 학술논문

【目的】分析本院泌尿外科手术患者术后猝死的发生过程及相关因素，为其预防措施提供相关依据。【方法】回顾性分析本院泌尿外科2000年1月至2013年12月38例术后猝死患者临床资料。其中男28例，女10例，年龄34～95（61．92±13．45）岁。按1∶2的匹配原则，随机抽取同期住院的泌尿外科的手术患者76例为对照组，年龄35～93（60．93±12．97）岁，比较两组相关临床资料，分析猝死相关危险因素。【结果】单因素分析显示猝死组心电图异常，高血压，术后止血药使用，术前合并冠心病及心功能不全、肺炎及肺功能不全、静脉血栓，长期卧床后突然起身活动，术后输血，再次手术的发生率均显著高于对照组，差异有统计学意义（ P ＜0．01，P ＜0．05）。Logistic多元回归分析，高血压，长期卧床后突然起身活动，术前合并冠心病和心功能不全、肺炎和肺功能不全与患者术后猝死密切相关（P ＜0．01，P ＜0．05）。【结论】“高血压”、“冠心病及心功能不全病史”、“长期卧床后突然起身活动”以及“术前肺炎和肺功能不全”是泌尿外科患者术后猝死的高危风险因素，临床工作中应对高危患者采取针对性的预防措施，以减少术后猝死的发生。
【목적】분석본원비뇨외과수술환자술후졸사적발생과정급상관인소，위기예방조시제공상관의거。【방법】회고성분석본원비뇨외과2000년1월지2013년12월38례술후졸사환자림상자료。기중남28례，녀10례，년령34～95（61．92±13．45）세。안1∶2적필배원칙，수궤추취동기주원적비뇨외과적수술환자76례위대조조，년령35～93（60．93±12．97）세，비교량조상관림상자료，분석졸사상관위험인소。【결과】단인소분석현시졸사조심전도이상，고혈압，술후지혈약사용，술전합병관심병급심공능불전、폐염급폐공능불전、정맥혈전，장기와상후돌연기신활동，술후수혈，재차수술적발생솔균현저고우대조조，차이유통계학의의（ P ＜0．01，P ＜0．05）。Logistic다원회귀분석，고혈압，장기와상후돌연기신활동，술전합병관심병화심공능불전、폐염화폐공능불전여환자술후졸사밀절상관（P ＜0．01，P ＜0．05）。【결론】“고혈압”、“관심병급심공능불전병사”、“장기와상후돌연기신활동”이급“술전폐염화폐공능불전”시비뇨외과환자술후졸사적고위풍험인소，림상공작중응대고위환자채취침대성적예방조시，이감소술후졸사적발생。
[Objective] To explore the influencing factors of sudden death in postoperative urological pa‐tients and provide rationales for formulating preventive measures .[Methods] For this case‐control study ,ret‐rospective analyses were conducted for 38 cases of sudden death from January 2000 to December 2013 .There were 28 males and 10 females with an average age of 61 .92 ± 13 .45 (34~95) years .According to the matc‐hing principle of 1 :2 ,another 76 surgical patients during the same period were selected into control group . Their average age was 60 .93 ± 12 .97 (35~93) years .[Results] The results of single factor analysis showed that the following 9 statistically significant factors :ECG abnormalities , hypertension , use of hemostatic drugs ,a history of coronary heart disease and heart failure ,sudden standing & activities ,preoperative pneu‐monia & pulmonary insufficiency ,preoperative venous thrombosis ,postoperative blood transfusion and reop‐eration .Multiple Logistic regression analysis showed that the following four items were closely correlated with sudden postoperative death :hypertension (OR=3 .27) ,sudden standing & activities (OR=15 .59) ,a history of coronary heart disease & heart failure (OR=5 .29) and preoperative pneumonia & pulmonary insufficiency (OR=6 .89) .[Conclusion] Hypertension ,a history of coronary heart disease & heart failure ,sudden stand‐ing & activities and preoperative pneumonia & pulmonary insufficiency are the postoperative risk factors of u‐rological patients .