Fujita T, Sakurai K
First Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
Am J Surg. 1995 Mar;169(3):304-7. doi: 10.1016/S0002-9610(99)80163-9.
Many risk factors for postoperative pneumonia have been identified, but those for the progression from atelectasis to pneumonia have been poorly examined. We undertook the present study to find risk factors for the progression from atelectasis to pneumonia.
We completed a retrospective analysis of 2,969 patients who underwent major abdominal surgery during the past 13 years.
Pneumonia developed in 45 patients (1.5%), and postoperative atelectasis with a high risk for the subsequent infection occurred in 44 patients in whom pneumonia did not develop. A series of 13 variables was compared in the two patient categories. By multivariate discriminant analysis, we identified three independent significant correlates of the development of postoperative pneumonia: blood loss of more than 1,200 mL during surgery, age over 65 years, and preoperative utilization of inhalation therapy devices.
This study shows that a substantial number of cases of postoperative pneumonia can be prevented.
已确定了许多术后肺炎的危险因素，但对于肺不张进展为肺炎的危险因素研究较少。我们开展本研究以寻找肺不张进展为肺炎的危险因素。
我们对过去13年中接受腹部大手术的2969例患者进行了回顾性分析。
45例患者（1.5%）发生肺炎，44例未发生肺炎的患者出现了有后续感染高风险的术后肺不张。对两组患者的一系列13个变量进行了比较。通过多变量判别分析，我们确定了术后肺炎发生的三个独立显著相关因素：手术期间失血超过1200毫升、年龄超过65岁以及术前使用吸入治疗装置。
本研究表明，相当一部分术后肺炎病例是可以预防的。
