【摘要】 目的探讨胃、十二指肠手术患者术后发生呼吸系统并发症(postoperativepulmonarycomplications,PPC)的危险因素。方法对1999年12月至2003年12月接受胃十二指肠手术的连续病例共508例患者的临床资料进行回顾性分析。采用单因素、多因素Logistic回归分析的方法筛选与发生PPC相关的危险因素。结果508例患者有131例(25.8%)发生PPC。多因素Logistic回归分析筛选出与PPC有关的危险因素为:年龄(OR=1.052)、术前伴存呼吸疾病(OR=2.915)、血清白蛋白水平(OR=0.995)、术中气管插管时间(OR=1.005)、保留鼻胃管时间(OR=1.059)、术后机械通气时间(OR=1.367)。得出Logistic回归预测方程为:P(1)=1/犤1+e-(-3.780+0.051×Y+1.086×Rd-0.005×Alb+0.005×Dtc+0.057×Dnt+0.312×Dmv)犦。结论高龄、有基础呼吸疾病、血清白蛋白水平低于正常、术中和术后留置胃管、气管插管、机械通气时间长者,易于发生PPC。更多还原

【Abstract】 Objective To investigate the risk factors for postoperat iv e pulmonary complications (PPC) after gastroduodenal operation. Methods From Dec ember 1999 to December 2003,clinical data of 508 patients undergoing gastroduode nal operation were analyzed retrospectively. Risk factors for PPC were screened. Results The complication rate of PPC was 25.8% (131/508). Multivariate logist ic regression analysis revealed that age (OR=1.052), history of respiratory dis eases (OR=2.915),serum albumin level (OR=0.995),length of intratracheal intubati on (OR=1.005),length of nasogastric intubation (OR=1.059) and length of postoper ative mechanical ventilation (OR=1.367) were risk factors for PPC. Conclusion Pa tients with old age,lower serum albumin level,intraoperative or postoperative na sogastric intubation,intratracheal intubation or long-term mechanical ventilat ion were more prone to develop PPC.更多还原