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重大头颈外科手术后的心血管和呼吸系统并发症

Cardiovascular and respiratory complications after major head and neck surgery.

作者信息

Buitelaar Dirk R, Balm Alfons J M, Antonini Ninja, van Tinteren Harm, Huitink Johannes M

机构信息

Department of Anesthesiology and Intensive Care, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.

出版信息

Head Neck. 2006 Jul;28(7):595-602. doi: 10.1002/hed.20374.

Abstract

BACKGROUND

Our aim was to gain insight into the incidence rates for, distribution of, and risk factors of postoperative cardiovascular and respiratory complications in major head and neck surgery.

METHODS

We performed a retrospective review of 469 patients who had undergone primary major head and neck surgery. Outcome measures were incidence rates, risk factors, and distribution over time for postoperative cardiovascular and respiratory complications. A multivariate analysis was performed.

RESULTS

The incidence rates for cardiovascular and respiratory complications were 57 of 469 (12%) and 50 of 469 (11%), respectively. The incidence rate for heart failure exceeded that for pneumonia. The peak incidence for cardiovascular complications was on the first postoperative day; for respiratory complications, on the second postoperative day. Risk factors for cardiovascular complications were age, pulmonary disease, alcohol abuse, and tumor location; risk factors for respiratory complications were pulmonary disease, previous myocardial infarction, and American Society of Anesthesiologists (ASA) grade.

CONCLUSION

In this study, the incidence rates for cardiovascular and respiratory complications were very similar. The first postoperative day was crucial with regard to cardiovascular complications. Age and chronic pulmonary diseases were the common risk factors for cardiovascular and respiratory complications.

摘要

背景

我们的目的是深入了解大型头颈外科手术后心血管和呼吸系统并发症的发生率、分布情况及危险因素。

方法

我们对469例行初次大型头颈外科手术的患者进行了回顾性研究。观察指标为术后心血管和呼吸系统并发症的发生率、危险因素及随时间的分布情况。进行了多因素分析。

结果

心血管和呼吸系统并发症的发生率分别为469例中的57例(12%)和469例中的50例(11%)。心力衰竭的发生率超过肺炎。心血管并发症的发病高峰在术后第一天;呼吸系统并发症的发病高峰在术后第二天。心血管并发症的危险因素为年龄、肺部疾病、酗酒和肿瘤位置;呼吸系统并发症的危险因素为肺部疾病、既往心肌梗死和美国麻醉医师协会(ASA)分级。

结论

在本研究中,心血管和呼吸系统并发症的发生率非常相似。术后第一天对心血管并发症至关重要。年龄和慢性肺部疾病是心血管和呼吸系统并发症的常见危险因素。

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