普胸外科手术围术期肺部并发症的防治分析  

Prevention and Treatment of Pulmonary Complications during Perioperative Period of General Thoracic Surgery

作　　者：胡广男 于大龙 张铭岳 朱凯 王立国 关永信 HU Guang-nan;YU Da-long;ZHANg Ming-yue;ZHU Kai;WANG Li-guo;GUAN Yong-xin(Department of Thoracic Surgery,Central Hospital of Yingkou Economic and Technological Development Zone(Yingkou Sixth People's Hospital),Yingkou 115007,China)

机构地区：[1]辽宁省营口经济技术开发区中心医院(营口市第六人民医院)胸外科,辽宁营口115007

出　　处：《中国医药指南》2020年第8期27-28,共2页Guide of China Medicine

摘　　要：目的探究普胸外科手术围术期肺部并发症的防治分析。方法选取我院2018年2月至2019年1月收纳治疗的普胸外科手术患者195例进行分组,数字随机法分为两组。对照组97例给予常规防治措施,研究组98例在对照组基础上加以盐酸氨溴索静脉滴注实施综合防治措施,对两组患者围术期并发症、手术前后1周时ICAM-A(细胞间黏附因子)、SP-A(肺表面活性物质蛋白-A)以及分析肺部感染影响因素。结果研究组围术期并发症5例,发生率5.10%,对照组并发症19例,发生率19.59%,组间差异显著(P<0.05);研究组术前1周ICAM-1、SP-A等与对照组无明显差异(P>0.05),术后1周分别为(604.85±126.65)ng/mL、(54.16±6.33)pmol/L,且较对照组差异显著(P<0.05);通过对并发症中肺部感染患者进行多因素Logistic回归分析后发现,患者肺部感染与营养不良、年龄、吸烟史、术后镇痛以及抗生素预防等存在关联。结论通过综合防治措施给予综合防治措施后取得显著成效,不仅降低肺部并发症发生率,还可改善患者肺部功能,提高生活质量,而针对肺部感染因素可给予针对性措施进行干预。Objective To explore the prevention and treatment of pulmonary complications during perioperative period of general thoracic surgery.Methods 195 cases of general thoracic surgery patients admitted to our hospital from February 2018 to January 2019 were divided into two groups by digital random method.97 cases in the control group were given routine preventive and therapeutic measures,98 cases in the study group were given ambroxol hydrochloride intravenous drip on the basis of the control group to implement comprehensive preventive and therapeutic measures.The perioperative complications,ICAM-A(intercellular adhesion factor),SP-A(pulmonary surfactant protein-A)and the influencing factors of pulmonary infection in the two groups were analyzed.Results There were 5 cases of perioperative complications in the study group(5.10%)and 19 cases in the control group(19.59%)with significant difference between the two groups(P<0.05).ICAM-1 and SP-A had no significant difference between the study group and the control group(P>0.05)one week before operation,and were(604.85±126.65)ng/mL and(54.16±6.33)pmol/L one week after operation,respectively,which were significantly different from those in the control group(P<0.05).Multivariate logistic regression analysis showed that pulmonary infection was associated with malnutrition,age,smoking history,postoperative analgesia and antibiotic prevention.Conclusin Comprehensive prevention and control measures have achieved remarkable results,which can not only reduce the incidence of pulmonary complications,but also improve the pulmonary function and quality of life of patients.Targeted interventions can be given for pulmonary infection factors.

关 键 词：普胸外科手术 围术期 肺部并发症 防治分析 

分 类 号：R655[医药卫生—外科学]