右半结肠切除术后呼吸系统并发症危险因素分析  

Risk factors of respiratory complications after right hemicolectomy

作　　者：何京晶[1] 李敏哲[2] 沈荐[2] HE Jingjing;LI Minzhe;SHEN Jian(Medical Examination Center,Beijing Chao-Yang Hospital Affiliated to Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院健康体检中心,100020 [2]首都医科大学附属北京朝阳医院普外科,100020

出　　处：《临床外科杂志》2021年第5期428-430,共3页Journal of Clinical Surgery

摘　　要：目的探讨右半结肠切除术后呼吸系统并发症的危险因素及预防措施。方法 2012年6月~2020年5月行右半结肠切除术病人336例,根据术后是否发生呼吸系统并发症,将其分为发生呼吸系统并发症组(25例)和未发生呼吸系统并发症组(311例)。对两组性别、年龄、体质量指数、长期吸烟史、呼吸系统基础疾病、糖尿病、麻醉危险度评分、术前白蛋白、术前血红蛋白、疾病性质、病变位置、手术类型、手术方式、是否遵循完整结肠系膜切除原则、手术时间及术中出血量指标进行单因素分析,对筛选出的有统计学意义的指标进行多因素Logistic回归分析。结果单因素分析显示,年龄≥65岁、合并呼吸系统基础疾病、急诊手术及手术时间>3小时与右半结肠切除术后呼吸系统并发症发生相关,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,年龄≥65岁及合并呼吸系统基础疾病是右半结肠切除术后呼吸系统并发症发生的独立危险因素(P<0.05)。结论老龄及呼吸系统基础疾病会加大右半结肠切除术后呼吸系统并发症的发生风险,行右半结肠切除术前需筛选高危人群,对老龄及罹患呼吸系统基础疾病的病人应采取合理的预防措施,以减少术后呼吸系统并发症的发生。Objective To investigate the risk factors of respiratory complications after right hemicolectomy, and to explore the prevention measures.Methods A total of 336 patients who underwent right hemicolectomy from June 2012 to may 2020 were selected as the study subjects.According to the occurrence of postoperative respiratory complications, they were divided into respiratory complications group(25 cases) and no respiratory complications group(311 cases).The gender, age, body mass index, long-term smoking history, respiratory diseases, diabetes, American Society of Anesthesiologists scores, preoperative albumin, preoperative hemoglobin, disease nature, lesion location, operation type, operation method, compliance with the principle of complete mesocolic excision, operation time, and bleeding during the operation were analyzed by univariate analysis and multivariate logistic regression.Results Univariate analysis showed that age ≥65 years, respiratory diseases, emergency surgery and operation time >3 hours related to respiratory complications after right hemicolectomy(P<0.05).Multivariate analysis showed that age ≥65 years and respiratory diseases were independent risk factors of respiratory complications after right hemicolectomy(P<0.05).Conclusion The elderly and respiratory diseases will increase the risk of respiratory complications after right hemicolectomy.High risk population should be screened before right hemicolectomy.Reasonable preventive measures should be taken for the patients who were old and had respiratory diseases to reduce the incidence of postoperative respiratory complications.

关 键 词：右半结肠切除 呼吸并发症 单因素分析 多因素分析 

分 类 号：R656.9[医药卫生—外科学]