消化道术后危重症患者并发症的临床分析  

Clinical analysis of complications in critically ill patientsafter gastrointestinal surgery

作　　者：余青[1] 王鹂 曾萍[1] YU Qing;WANG Li;ZENG Ping(Department of critical medicine,Xiamen Hospital of traditional Chinese medicine,Xiamen,Fujian,361000,China)

机构地区：[1]厦门市中医院重症医学科,福建厦门361000

出　　处：《新疆医学》2023年第1期62-64,122,共4页Xinjiang Medical Journal

摘　　要：目的 探讨消化道术后危重症患者并发症的相关情况、发生的原因及预防和减少其发生的有关措施。方法 对厦门市中医院重症医学科2015年1月-2019年12月31例消化道术后危重症患者并发症情况进行回顾性分析。结果 31例消化道术后危重患者共发生术后并发症14例,发生率为45.16%(9例仅发生1种并发症,2例发生2种并发症,3例发生2种以上并发症),其中肺部感染9例(23.03%)、腹腔感染4例(12.9%)、消化道瘘4例(12.9%),其他并发症6例(19.35%)。术中休克患者术后有60%发生并发症,术中无休克患者术后有38%发生并发症;术后发生并发症患者与未发生并发症的患者相比,其重症监护室(ICU)住院时间(d)延长(9.50 vs 3.00),住院费用(万元)增加(5.88 vs 2.86),住院死亡率升高(21.42%vs 0%)(P <0.05),有显著统计学意义。结论 消化道术后危重症患者可发生多种并发症,与手术时机、术中休克及抗生素选择等因素明显相关;出现并发症会显著延长ICU滞留时间、增加医疗花费、增加死亡率。Objective To explore the related situation and causes of complications in critically ill patients after gastrointestinal surgery, and to find the measures to prevent and reduce them. Methods The complications of 31 critically ill patients after gastrointestinal surgery in the department of critical medicine of Xiamen hospital of traditional Chinese medicine from January 2015 to December 2019 were analyzed retrospectively. Results There were 14 postoperative complications in 31 critical patients after gastrointestinal surgery, with an incidence of 45.16%(Among them, 9 cases had only one kind of complication, 2 cases had two kinds of complication, and 3 cases had more than two kinds of complication). There were 9 cases of pulmonary infection(accounting for 23.03%),4 cases of abdominal infection(accounting for 12.9%), 4 cases of gastrointestinal fistula(accounting for 12.9%), and 6 cases of other complications(accounting for 19.35%). Complications occurred in 60% of patients with intraoperative shock and 38% of patients without intraoperative shock. Compared with the patients without complications, the length of stay(days)in intensive care unit(ICU)was prolonged(9.50 vs 3.00), the hospitalization cost(ten thousand yuan)was increased(5.88 vs 2.86), and the hospitalization mortality was increased(21.42% vs 0%)(P < 0.05). Conclusion There were many complications in critical patients after gastrointestinal surgery,which are significantly related to the timing of operation, intraoperative shock and the choice of antibiotics;The occurrence of complications will significantly prolong the stay time in ICU, increase medical expenses and increase mortality.

关 键 词：消化道手术 危重症患者 并发症 

分 类 号：R605.97[医药卫生—急诊医学]