食管癌术后急性呼吸衰竭患者心功能危险因素分析

摘要

Objective To analyze the risk factors of cardiac function in patients with acute respiratory failure( Acute re-spiratory failure,ARF) after the operation of esophageal cancer in intensive care unit( Intensive Care Units,ICU) . Methods The clinical data of patients with acute respiratory failure after esophageal cancer operation undergoing mechanical ventilation in ICU from January 2011 to January 2015 were compared with the data of patients with esophageal cancer who did not have ARF after sur-gery during the same period. Logistic regression analysis was used to predict the risk factors of cardiac function in patients with a-cute respiratory failure after operation. Results After operation 48 cases of esophageal cancer occurred ARF in 256 cases. Logistic regression analysis revealed that the brain natriuretic peptide ( Brain natriuretic Peptide, BNP ) level ( OR = 2. 145; 95% CI 2. 649-4. 840)and postoperative fluid balance(OR=1. 226;95%CI 1. 023-2. 826)were the independent risk factors for predicting postoperative ARF. Conclusion Restriction of fluid management guided by BNP after surgery may be an important link to prevent and reduce the occurrence of postoperative ARF in patients with esophageal cancer.%目的 分析重症监护病房(Intensive Care Units,ICU)食管癌术后发生急性呼吸衰竭((Acute respiratoryfail-ure,ARF)需机械通气患者的心功能危险因素.方法 将2011年1月至2015年1月期间食管癌术后发生急性呼吸衰竭进入ICU行机械通气患者临床资料,与同期术后未发生ARF的食管癌患者的资料做对照,应用Logistic回归分析预测术后发生急性呼吸衰竭的心功能危险因素.结果 256例食管癌术后48例发生ARF.Logistic回归分析发现术后脑钠肽(Brain natriuretic Peptide,BNP)水平(OR=2.145;95%CI 2.649~4.840)及术后液体正平衡(OR=1.226;95%CI 1.023~2.826)是预测术后可能发生ARF的独立危险因素.结论 术后以BNP为指导进行限制性液体管理,可能是预防和减少食管癌术后ARF发生的重要环节.