ICU食管癌术后肺部并发症的临床调查研究

摘要

目的：探讨ICU食管癌术后肺部并发症情况，分析其危险因素。方法：选取2012年2月到2015年2月115例食管癌患者为研究对象，均手术治疗并入ICU观察，分析并发症发生率情况及危险因素。结果：并发症总发生率26.96%，其中肺炎发生率41.94%，气胸发生率12.90%，胸腔积液发生率9.68%，呼吸衰竭发生率19.35%，脓胸发生率9.68%，急性呼吸窘迫综合征发生率6.45%，肺炎发生率和其他并发症发生率比较差异有统计学意义（ P﹤0.05）。ICU食管癌术后肺部并发症单危险因素有年龄（≥65岁）、术中出血量（≥500ml）、吸烟、有基础疾病、营养状态差、肿瘤分期高（Ⅲ期）、手术经弓前入路、术后存在并发症、术后硬膜外未镇痛等（P均﹤0.05），均为独立危险因素（P均﹤0.05），而和吻合方法无关（P﹥0.05）。结论：ICU食管癌术后肺部并发症和患者本身、手术因素关联性较大。%Objective:To investigate the postoperative pulmonary complications,and the risK factors,early inter-vention in ICU. Methods:February 2012 to February 2015,115 cases of esophageal cancer patient in ICU enrolled in the study,analyze the incidence of complications,and the risK factors . Results:The overall complication rate was 26. 96%,of which 41. 94% of pneumonia,pneumothorax 12. 90%,9. 68% pleural effusion,respiratory failure rate was 19. 35%,the incidence of empyema 9. 68%,the incidence of acute respiratory distress syndrome 6. 45%,the in-cidence of pneumonia and other complications incidence difference was statistically significant(P﹤0. 05). ICU post-operative pulmonary complications risK factors are age(≥65 years old),blood loss(≥500ml),smoKing,underlying diseases,poor nutritional status,high tumor stage(Ⅲ stage),postoperative epidural analgesia(P﹤0. 05). But unre-lated with anastomosis(P﹥0. 05). Conclusion:ICU postoperative pulmonary complications are related with patients status surgical factors,greater.