老年腹部大手术患者术后肺部并发症及相关因素分析  

Analysis of pulmonary complications and related factors in elderly patients following major abdominal surgery

作　　者：曲宗阳 周淑珍[1] 包杰 杨明[1] 刘鹏[1] 张静静[1] 张宏业[1] 左明章[1] Qu Zongyang;Zhou Shuzhen;Bao Jie;Yang Ming;Liu Peng;Zhang Jingjing;Zhang Hongye;Zuo Mingzhang(Department of Anesthesiology,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京医院手术麻醉科,国家老年医学中心,中国医学科学院老年医学研究院,100730

出　　处：《中华老年医学杂志》2020年第9期1034-1037,共4页Chinese Journal of Geriatrics

基　　金：首都特色临床应用研究(Z161100000516135)。

摘　　要：目的分析老年腹部大手术患者术后肺部并发症发生情况及相关因素。方法回顾性分析北京医院实施老年大型腹部手术患者的临床资料,对患者术后肺部并发症发生率进行描述,采用Logistic回归分析术后肺部并发症发生的相关因素。结果最终纳入分析96例患者资料,老年腹部大手术术后肺部并发症发生率为53.1%(51/96);Logistic回归分析结果显示,腹腔镜手术(OR=0.293,95%CI:0.100~0.865,P=0.026)是肺部并发症发生的保护因素,而驱动压力>18 cmH2O(1 cmH2O=0.098 kPa)(OR=3.300,95%CI:1.148~9.434,P=0.027)和术中出血量>500 ml(OR=4.444,95%CI:1.091~18.180,P=0.037)是肺部并发症发生的危险因素。结论老年患者腹部大手术术后肺部并发症发生率值得关注,腹腔镜手术是术后肺部并发症发生的保护因素,而驱动压力>18 cmH2O和出血量>500 ml会增加肺部并发症发生的风险。Objective To analyze the incidence of postoperative pulmonary complications and related factors in elderly patients after major abdominal surgery.Methods Clinical data of elderly patients undergone major abdominal surgeries at Beiing Hospital were retrospectively analyzed.The incidence of postoperative pulmonary complications was studied,and related factors were analyzed using Logistic regression analysis.Results A total of 96 cases were included.The incidence of postoperative pulmonary complications was 53.1%(51/96)in elderly patients after major abdominal surgery.Logistic regression analysis showed laparoscopy was a protective factor for postoperative pulmonary complications(OR=0.293.95%CI:0.100-0.865,P=0.026),while driving pressure>18 cmH2O(1 cmH2O=0.098 kPa)(OR=3.300.95%CI:1.148-9.434.P=0.027)and intraoperative bleeding volume>500 ml(OR=4.444.95%CI:1.091-18.180,P=0.037)were risk factors for postoperative pulmonary complications.Conclusions Attention should be paid to the incidence of postoperative pulmonary complications in elderly patients after major abdominal surgery.Laparoscopy is a protective factor for postoperative pulmonary complications,while driving pressure more than 18 cmH2O and intraoperative bleeding volume more than 500 ml can increase the risk of postbperative pulmonary complications.

关 键 词：肺损伤 手术后并发症 腹部 

分 类 号：R656[医药卫生—外科学]