术后发生急性肺损伤的危险因素分析  

Risk factors of Postoperative acute lung injury

作　　者：钟宝琳[1] 黄桂明[1] 李以平[1] 陈以健[1] 李优春[1] 

机构地区：[1]江西省赣州市人民医院麻醉科,341000

出　　处：《临床麻醉学杂志》2015年第9期888-890,共3页Journal of Clinical Anesthesiology

摘　　要：目的 探讨术后发生急性肺损伤（ALI）的危险因素。方法 回顾性分析我院2009年2月至2013年12月的择期手术患者1 309例,其中术后发生ALI患者38例、未发生ALI患者1 271例,对两组临床资料进行单因素和多因素Logistic回归分析。结果 单因素分析结果显示,与非ALI患者比较,ALI患者年龄〉60岁、高风险手术（心脏、主动脉、胸部）、糖尿病、慢性阻塞性肺疾病、限制性肺疾病、胃食管反流病、肝硬化、吸烟和酗酒的例数明显增加（P〈0.05）。多因素Logistic回归分析显示,术后发生ALI的危险因素为高风险心脏手术（OR=7.27,95%CI 3.73～11.52）、主动脉手术（OR=18.41,95%CI 8.91～32.77）、胸部手术（OR=5.55,95%CI 2.27～9.08）、糖尿病（OR=1.72,95%CI 1.26～3.31）、慢性阻塞性肺疾病（OR=2.85,95%CI 1.60～4.28）、胃食管反流病（OR=2.07,95%CI 1.37～2.89）和酗酒（OR=2.32,95%CI 1.48～3.31）（P〈0.05）。结论 高风险手术（心脏、主动脉、胸部）、糖尿病、慢性阻塞性肺疾病、胃食管反流病和酗酒是术后发生ALI的危险因素。Objective To investigate the risk factors of postoperative acute lung injury（AM）. Methods We retrospectively analysis 1 309 patients undergoing elective surgery from February 2009 to December 2013, of which 38 cases developed postoperative ALI. Preoperative clinical data for post- operative ALI were evaluated by univariate and multivariate Logistic regression, dentified and evalua- ted by univariate and multivariate Logistic regression. Results Univariate analysis showed that older age C〉60 years）,high risk surgery （heart, aorta, thoracic surgery）, diabetes, chronico bstructive pulmonary disease, restrictive lung disease, gastroesophageal reflux disease, cirrhosis, alcohol abuse and smoking are relevant with postoperative ALI （P〈0.05）. Logistic regression analysis shown that the risk factors of postoperative ALI include high-risk cardiac surgery （OR= 7.27, 95%CI 3.73- 11.52） ,high-risk aortic surgery（OR= 18.41,95 %CI 8.91-32.77）, high risk thoracic surgery（OR= 5.55,95 % CI 2.27-9.08）, diabetes mellitus （OR= 1.72,95 % CI 1.26-3.31）, chronic obstructive pul- monary disease （OR= 2.85,95% CI 1.60-4. 28）, gastroesophagealreflux disease （OR： 2.07,95% CI 1.37-2.89） and alcohol abuse （OR=2.32,95%CI 1.48-3.31）（P〈0.05）. Conclusion High-risk sur- gery （cardiac, aortic and vascular and thoracic）,diabetes mellitus,chronic obstructive pulmonary dis- ease, gastroesophageal reflux disease, and alcohol abuse are the risk factors of postoperative ALI.

关 键 词：手术 急性肺损伤 危险因素 

分 类 号：R619[医药卫生—外科学]