老年患者腹腔感染术后肺损害的防治  

PREVENTION AND TREATMENT OF PNEUMONIC INJURY AFTER OPERATION IN AGED PATIENTS WITH ABDOMINAL INFECTION

作　　者：陈丽莉[1] 王红鹰[1] 蒿汉坤[1] 

机构地区：[1]上海医科大学附属华山医院普外科

出　　处：《中国普外基础与临床杂志》1999年第5期294-295,共2页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：为探讨老年患者腹腔感染术后肺损害的发生及其防治措施，对我院外科 １９９１ 年 １ 月至 １９９２ 年 １２ 月收治的７７ 例 ６０ 岁以上的腹部外科疾病患者，术后给吸氧处理后的血氧饱和度（ Ｓａ Ｏ２ ）进行了连续监测，其中伴腹腔感染者（感染组）３８ 例，无腹腔感染者（非感染组）３９ 例。结果： 感染组术后 Ｓａ Ｏ２ ＜ ９５％ 者 ２８ 例，其低氧血症发生率为 ７３．７％ ，非感染组 Ｓａ Ｏ２ ＜ ９５％ 者 １２ 例，其低氧血症发生率为３０．８％ ，两组比较差异有显著性意义（ Ｐ＜ ０．００１）。对术后 Ｓａ Ｏ２ ＜ ９５％ 的４０ 例患者给予吸氧处理后，其低氧血症得以改善３１ 例，有效率达 ７７．５％ ； 而低氧血症未纠正者 ９ 例，均并发成人呼吸窘迫综合征（ Ａ Ｒ Ｄ Ｓ），发生率为 ２．５％ （９／４０），其中感染组并发 Ａ Ｒ Ｄ Ｓ者 ８ 例，发生率为 ２１．１％ ，非感染组 １ 例，发生率为２．６％ ，两组比较，差异有显著性意义（ Ｐ＜ ０．０５）。该结果提示： 老年患者腹腔感染术后易并发低氧血症，且易发展成 Ａ Ｒ Ｄ Ｓ。因此老年患者腹腔感染术后，常规进行血氧饱和度的临床监测和吸氧治疗，是防治肺损害的重要措施之一。To evaluate the development prevention and treatment of pneumonic injury after operation on aged patients with abdominal infection. We analyzed 77 aged patients (>60 y) admitted from Jan. 1991 to Dec. 1992: 38 cases of which with abdominal infection (infection group), 39 cases without abdominal infection (non infection group). All patients were given oxygen therapy and continuous SaO 2 monitoring. Results: There were 28 patients with hypoxemia (SaO 2<95%) in infection group, with an occurrence rate of 73.7%. In non infection group (12 patients), the rate of hyoxemia was 30.8%, which has significant difference between two groups ( P <0.001). All patients with hypoxemia were given oxygen therapy and 31 patients′ SaO 2 was elevated. The efficient rate was 77.5%. Other 9 patients developed ARDS, the rate was 2.5% (9/40). In the infection group 8 patients developed ARDS with an occurrence rate of 21.1%. There was one patient with ARDS in the non infection group, the rate was 2.6%. There was significant difference between two group ( P <0.05). Conclusions: The results suggest that hypoxemia is liable to occur in aged patients with abdominal infection after operation and these patients were liable to develop ARDS. Oxygen therapy and SaO 2 monitoring is the important managements to these patients in prevention of pneumonic injury.

关 键 词：腹腔感染 术后 肺损害 防治 

分 类 号：R563.01[医药卫生—呼吸系统] R656.05[医药卫生—内科学]