Menke H, Klein A, Böttger T, Lorenz W, Bahr W, Junginger T
Klinik für Allgemein- und Abdominalchirurgie, Johannes-Gutenberg-Universität Mainz.
Chirurg. 1992 Jul;63(7):548-54.
Incidence and type of postoperative complications were prospectively analyzed in 2280 patients undergoing gastrointestinal surgery. 6.6% had one or more pulmonary complications requiring therapeutic intervention (2.3% pneumonia, 1.6% drained pleural effusions, 1.2% atelectases). Based on univariate and logistic regression analyses, the following parameters constitute high-risk patients with regard to pulmonary complications: Elective surgery (4.3%, 61/1428): anemia (7.2% pulmonary complications), pathological blood gas analysis (9.8%), preoperative hospitalization greater than 1 week (6.3%), blood loss under operations greater than 1000 ml (10.5%), length of the operation greater than 3 h (9.7%); emergency surgery (10.4%, 89/852): upper gastrointestinal operation (16.2%), age greater than 75 (19.9%), ASA IV/V (28%), anemia (19.6%), chronic bronchitis (19%), pathological blood gas analysis (26.6%), diabetes (16.5%), heart failure (18.2%), blood loss under operation greater than 1000 ml (24.3%), length of the operation greater than 2 h (15.4%). These results allow to distinguish between different levels of pulmonary risk.
对2280例接受胃肠手术的患者术后并发症的发生率和类型进行了前瞻性分析。6.6%的患者发生了一种或多种需要治疗干预的肺部并发症（2.3%为肺炎，1.6%为胸腔积液引流，1.2%为肺不张）。基于单因素分析和逻辑回归分析，以下参数表明患者发生肺部并发症的风险较高：择期手术（4.3%，61/1428）：贫血（肺部并发症发生率为7.2%）、血气分析异常（9.8%）、术前住院时间超过1周（6.3%）、术中失血超过1000 ml（10.5%）、手术时间超过3小时（9.7%）；急诊手术（10.4%，89/852）：上消化道手术（16.2%）、年龄大于75岁（19.9%）、美国麻醉医师协会（ASA）分级为IV/V级（28%）、贫血（19.6%）、慢性支气管炎（19%）、血气分析异常（26.6%）、糖尿病（16.5%）、心力衰竭（18.2%）、术中失血超过1000 ml（24.3%）、手术时间超过2小时（15.4%）。这些结果有助于区分不同程度的肺部风险。
