食管贲门癌术后急性呼吸衰竭的危险因素分析

摘要

目的 探讨导致食管癌和贲门癌术后发生急性呼吸衰竭(ARF)的危险因素.方法 收集海南省人民医院自2000年以来手术治疗的204例食管癌和贲门癌患者的临床资料,采用单因素和多因素Logistic回归分析方法分析,筛选出可能导致食管癌和贲门癌术后发生ARF的危险因素.统计分析采用SPSS11.5软件,P<0.05为差异有统计学意义.结果 术前有肺部合并症、术前合并糖尿病、术前肺功能中重度损害、手术持续时间>4 h、术后二次开胸手术五个变量的偏回归系数分别为:1.633、2.381、3.185、1.610、4.827(P<0.05),而术后镇痛的偏回归系数为-2.373(P<0.05).结论 食管癌、贲门癌术后发生急性呼吸衰竭是由多种因素共同作用所致,在对手术风险评估时应尤其注意术前有肺部合并症、术前合并糖尿病、术前肺功能中重度损害、手术持续时间长、术后二次开胸手术等这几个危险因索.%Objective To discuss the risk factors of postoperative acute respiratory failure in esophageal carcinoma and cardiac carcinoma patients. Methods 204 esophageal carcinoma and cardiac carcinoma patients who were received surgical treatment since 2000 were analyzed retropectvely. Univariable analysis and multivariable analysis with logistic regression was performed for the selected risk factors. We used SPSS 13.0 software package for statistical analysis. Significance was set at P＜0.05. Results Preoperative pulmonary complications, preoperative diabetes,bad preoperative respiratory function, duration of operation more than 4 hours, postoperative secondary thoracotomy,partial regression coefficients of five variables were: 1.633, 2.381, 3.185, 1.610, 4.827 (P＜0.05), and postoperative analgesia partial regression coefficient was-2.373 (P＜0.05). Conclusion Postoperative acute respiratory failure in esophageal carcinoma and cardiac carcinoma patients are caused by multiple factors, such as preoperative pulmonary complications, preoperative diabetes, bad preoperative respiratory function, duration of operation more than 4 hours and postoperative secondary thoracotomy.