食管贲门手术患者术后肺炎危险因素分析  

Risk Factors of Postoperative Pneumonia in Patients undergoing Esophageal Cardia Surgery

作　　者：夏娟[1] 顾成武[1] 江冬萍[1] 刘建平[2] 李虹[1] 左素清 李艳霞[1] 王晓红[1] 何莲芬 XIA Juan;GU Chengwu;JIANG Dongping;LIU Jianping;LI Hong;ZUO Suqing;LI Yanxia;WANG Xiaohong;HE Lianfen(Department of Infection Management,Suining Central Hospital,Suining 629000,China;Suining Central Hospital Cardiovascular Center,Suining 629000,China)

机构地区：[1]遂宁市中心医院医院感染管理科,四川遂宁629000 [2]遂宁市中心医院心血管中心,四川遂宁629000

出　　处：《中国医药指南》2023年第25期9-12,共4页Guide of China Medicine

摘　　要：目的了解食管贲门手术患者术后发生肺炎的危险因素,进一步探讨相应预防措施。方法回顾性分析我院胸外科2020年3月至2021年3月接受手术治疗的食管贲门相关疾病患者的病历资料,统计分析术后肺炎发生情况及其相关危险因素。结果食管贲门手术患者共178例,其中发生术后肺炎106例,发生率高达59.56%;单因素分析结果显示,年龄≥65岁、恶性肿瘤、胸腹联合手术方式、术前空腹血糖≥6.0 mmol/L、慢性阻塞性肺疾病、血清白蛋白<40 g/L、术前胸部CT提示急慢性炎症、手术时间≥300 min、手术前住院时间≥10 d、术前合并贫血与术后肺炎的发生相关,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,恶性肿瘤、胸腹联合手术方式、术前空腹血糖≥6.0 mmol/L、术前CT提示肺部急慢性炎、手术前住院时间≥10 d、术前合并贫血是导致术后肺炎的独立危险因素(P<0.05)。结论食管贲门手术后肺炎的发生率较高,严重影响患者预后,延长患者的住院时间。临床医师应针对肺炎相关危险因素做好相应的预防措施,从而降低术后肺炎的发生率。Objective To understand the risk factors of postoperative pneumonia in patients undergoing esophagea cardia surgery and explore the corresponding preventive measures.Methods The clinical data of patients with esophageal cardia-related diseases who underwent surgery in the Department of Thoracic Surgery of our hospital from March 2020 to March 2021 were retrospectively analyzed,and the incidence of postoperative pneumonia and related risk factors were statistically analyzed.Results Of the 178 patients who underwent esophageal cardia surgery,106 cases developed postoperative pneumonia,incidence rate was 59.56%.The results of univariate analysis showed that age≥65 years,malignant tumor,combined thoracoabdominal surgery,preoperative fasting blood glucose≥6.0 mmol/L,chronic obstructive pulmonary disease,serum albumin<40 g/L,acute and chronic inflammation suggested by preoperative chest CT,operation time≥300 minutes,preoperative hospital stay≥10 days,preoperative anemia and postoperative pneumonia,and the difference was statistically significant(P<0.05).The results of multivariate Logistic regression analysis showed that malignant tumors,combined thoracic and abdominal surgery,preoperative fasting blood glucose≥6.0 mmol/L,preoperative CT suggesting acute and chronic pulmonary inflammation,preoperative hospital stay≥10 days,and preoperative anemia were independent risk factors for postoperative pneumonia(P<0.05).Conclusion The incidence of postoperative pneumonia after esophageal cardia surgery is high,which seriously affects the prognosis of patients,increases the length of hospital stay.Clinicians should take preventive measures based on the relevant risk factors related to postoperative pneumonia,so as to reduce the incidence of postoperative pneumonia.

关 键 词：外科手术 肺炎 术后并发症 危险因素 

分 类 号：R61[医药卫生—外科学] R563.1[医药卫生—临床医学]