胃肠道手术后肺部并发症风险的多变量分析。
Multivariate analysis of the risk for pulmonary complication after gastrointestinal surgery.
作者信息
Jiang Shan-Ping, Li Zhi-Ying, Huang Li-Wen, Zhang Wei, Lu Zhi-Qiang, Zheng Zhi-Yong
机构信息
Department of Respiratory Medicine, the Second Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510120, Guangdong Province, China.
出版信息
World J Gastroenterol. 2005 Jun 28;11(24):3735-41. doi: 10.3748/wjg.v11.i24.3735.
AIM
To identify the risk factors for postoperative pulmonary complications (PPC) after gastrointestinal surgery.
METHODS
A total of 1 002 patients undergoing gastrointestinal surgery in the Second Affiliated Hospital, Sun Yat-Sen University, during December 1999 and December 2003, were retrospectively studied.
RESULTS
The overall incidence of PPC was 22.8% (228/1,002). Multivariate logistic analysis identified nine risk factors associated with PPC, including age odds ratio (OR = 1.040) history of respiratory diseases (OR = 2.976), serum albumin (OR = 0.954), chemotherapy 2 wk before operation (OR = 3.214), volume of preoperative erythrocyte transfusion (OR = 1.002), length of preoperative antibiotic therapy (OR=1.072), intraoperative intratracheal intubation (OR = 1.002), nasogastric intubation (OR = 1.050) and postoperative mechanical ventilation (OR = 1.878). Logistic regression equation for predicting the risk of PPC was P(1) = 1/[1+e(-(-3.488+0.039 x Y+1.090 x Rd+0.001 x Rbc-0.047 x Alb+0.002 x Lii+0.049 x Lni+0.630 x Lmv+0.070 x Dat+1.168 x Ct))].
CONCLUSION
Old patients are easier to develop PPC.
目的
确定胃肠手术后肺部并发症（PPC）的危险因素。
方法
回顾性研究1999年12月至2003年12月在中山大学附属第二医院接受胃肠手术的1002例患者。
结果
PPC的总发生率为22.8%（228/1002）。多因素logistic分析确定了9个与PPC相关的危险因素，包括年龄比值比（OR = 1.040）、呼吸系统疾病史（OR = 2.976）、血清白蛋白（OR = 0.954）、术前2周化疗（OR = 3.214）、术前红细胞输注量（OR = 1.002）、术前抗生素治疗时间（OR = 1.072）、术中气管插管（OR = 1.002）、鼻胃管插管（OR = 1.050）和术后机械通气（OR = 1.878）。预测PPC风险的logistic回归方程为P(1) = 1/[1+e(-(-3.488+0.039 x Y+1.090 x Rd+0.001 x Rbc-0.047 x Alb+0.002 x Lii+0.049 x Lni+0.630 x Lmv+0.070 x Dat+1.168 x Ct))]。
结论
老年患者更容易发生PPC。
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