胃癌切除患者术后低氧血症相关危险因素分析  

Analysis risk factors related to postoperative hypoxemia in patients undergoing gastric cancer resection

作　　者：薛然荣 方晓霞 沈裕厚 XUE Ran-rong;FANG Xiao-xia;SHEN Yu-hou(Department of Anesthesiology and Perioperative Medicine,Xinxiang Central Hospital,the Fourth Clinical College of Xinxiang Medical University,Xinxiang,Henan 453000,China;Xinxiang Key Laboratory of Elderly Health Care and Promotion,Xinxiang Central Hospital,the Fourth Clinical College of Xinxiang Medical University,Xinxiang,Henan 453000,China;Department of General Oncology Surgery,Xinxiang Central Hospital,the Fourth Clinical College of Xinxiang Medical University,Xinxiang,Henan 453000,China)

机构地区：[1]新乡市中心医院,新乡医学院第四临床学院麻醉与围术期医学科,河南新乡453000 [2]新乡市中心医院,新乡医学院第四临床学院,新乡市老年健康照护与促进重点实验室,河南新乡453000 [3]新乡市中心医院,新乡医学院第四临床学院普瘤外科,河南新乡453000

出　　处：《医药论坛杂志》2025年第1期8-11,16,共5页Journal of Medical Forum

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20210913)。

摘　　要：目的探讨胃癌切除患者术后低氧血症的危险因素,旨在为麻醉医师筛选高危患者提供参考。方法回顾性分析2023年1月—2024年4月在新乡市中心医院进行胃癌切除手术的200例患者临床资料,根据患者术后是否发生低氧血症将患者分为低氧血症组和非低氧血症组。采用单因素方差分析和二元logistic回归分析胃癌切除患者术后低氧血症的危险因素。结果200例胃癌切除手术患者术后发生低氧血症者53例,占26.50%。二元logistic回归分析结果显示,年龄>65岁、BMI>25 kg/m^(2)、ASA分级Ⅲ级或Ⅱ级、麻醉时长>3 h、手术时长>4 h、术中地佐辛或右美托咪定辅助镇痛、术前SpO2<95%是胃癌切除患者术后发生低氧血症的危险因素(P<0.05)。结论胃癌切除手术患者术后低氧血症发生率较高,年龄>65岁、BMI>25 kg/m^(2)、ASA分级Ⅲ级或Ⅱ级、麻醉时长>3 h、手术时长>4 h、术中地佐辛或右美托咪定辅助镇痛、术前SpO2<95%是胃癌切除患者术后发生低氧血症的危险因素,麻醉医师应警惕高危患者,及时吸氧,以防术后低氧血症的发生。Objective To explore the risk factors for postoperative hypoxemia in patients undergoing gastric cancer resection and to provide reference for anesthesiologists in screening high-risk patients.Methods Retrospectively analyzed the clinical data of 200 patients who underwent gastric cancer resection surgery in the Xinxiang Central Hospital from January 2023 to April 2024,they were divided into hypoxemia group and non hypoxemia group based on whether they developed hypoxemia after surgery.Using one-way analysis of variance and binary logistic regression to analyze the risk factors for postoperative hypoxemia in patients undergoing gastric cancer resection.Results Among 200 patients who underwent gastric cancer resection surgery,53 cases developed hypoxemia after surgery,which accounting for 26.50%.The results of binary logistic regression analysis showed that age>65 years,BMI>25 kg/m^(2),ASA gradeⅢorⅡ,anesthesia duration>3 hours,surgical duration>4 hours,intraoperative adjuvant analgesia with dezocine or dexmedetomidine,and preoperative SpO_2<95%were risk factors for postoperative hypoxemia in gastric cancer resection patients(P<0.05).Conclusion The incidence of postoperative hypoxemia in patients undergoing gastric cancer resection surgery is relatively high,(with age>65 years,BMI>25 kg/m^(2),ASA gradeⅢorⅡ,anesthesia duration>3 hours,surgical duration>4 hours,intraoperative adjuvant analgesia with dexmedetomidine or dexmedetomidine,and preoperative SpO_2<95%were risk factors for postoperative hypoxemia in gastric cancer resection patients),anesthesiologists should be alert to high-risk patients and promptly administer oxygen to prevent the occurrence of postoperative hypoxemia.

关 键 词：胃癌切除术 低氧血症 危险因素 

分 类 号：R735.2[医药卫生—肿瘤]