肺切除术后低氧血症的发生规律及危险因素分析  

Postoperative hypoxemia after lung resection:time course and risk factors

作　　者：刘海波[1] 李简[1] 刘桐林[1] 

机构地区：[1]北京大学第一医院胸外科,北京100034

出　　处：《中国现代医学杂志》2007年第17期2116-2119,共4页China Journal of Modern Medicine

摘　　要：目的观察肺切除术后低氧血症的发生规律,并分析相关的危险因素。方法对112例肺切除手术患者行前瞻性围术期脉搏氧饱和度连续监测,同时收集相关临床数据,应用SPSS软件进行多因素Logisic回归分析。结果肺切除术后低氧血症发生率可达50%;其中术后第1天低氧血症发生率和严重程度最高,为48.2%;在术后第3～5天恢复最为迅速;至术后1周时大部分患者SpO2可恢复到94%以上。多因素分析显示肺切除术后发生低氧血症的独立危险因素有老年(odds ratio,5.9)、超重(odds ratio,7.2)、高术后疼痛评分(odds ra-tio,1.8)和系统性纵隔淋巴结清扫(odds ratio,4.1)。结论肺切除术后低氧血症发生率较高,其变化呈现一定规律;老年、超重、高术后疼痛评分、系统性纵隔淋巴结清扫是肺切除术后发生低氧血症的独立危险因素。[Objective] To find out the time course and the independent risk factors of hypoxemia after lung resection. [Methods] 112 consecutive patients who underwent selected lung resection were studied by continuous pulse oximetry （SpOt.） measurement, while perioperative data was collected and analysed by a multi-factors logistic regression test. [Result] Hypoxemia after lung resection had a very high incidence of 50%; in the first day after surgery, hypoxemia occurred most seriously, but it recovered soon, especially from the postoperative 3rd day to the 5th day. And to the 7th day, 87.5% of the patients had recovered their SpO2, above 94%. Four independent risk factors for hypoxemia after lung resection were identified： old age, overweight, the higher average Prince Henry pain scale scores and systematic mediastinal lymphnode dissection. [Conclusion] The incidence of hypoxemia is high after lung resection, and the time course of hypoxemia indicated some characteristics. Old age, overweight, the higher average Prince Henry pain scale scores and systematic mediastinal lymphnode dissection were the independent risk factors of hypoxemia after lung resection.

关 键 词：肺切除术 低氧血症 系统性纵隔淋巴结清扫 脉搏氧饱和度监测 

分 类 号：R655.3[医药卫生—外科学]