肝癌外科手术后肺部并发症危险因素分析

摘要

目的 探讨肝癌外科手术后肺部并发症相关的危险因素.方法 选取2014年3月-2016年4月在第四军医大学第一附属医院西京医院肝胆胰脾外科进行肝癌外科手术的患者160例作为研究对象,分析肝癌外科手术后肺部并发症发生情况,并根据是否发生肺部并发症分为观察组(发生肺部并发症)与对照组(无肺部并发症),对发生术后肺部并发症的危险因素进行分析.结果 经单因素分析显示,患者年龄、吸烟史、脑血管意外史、肺部疾病史、手术持续时间、术中出血量、术后带呼吸机、预防性使用抗生素、术后应用镇痛泵与肝癌患者术后肺部感染有关(P＜0.05);经Logistic多因素分析显示,患者的年龄、肺部疾病史、手术时间及术后应用镇痛泵是肝癌患者术后发生肺部感染的独立危险因素.结论 肝癌患者外科手术后引发肺部并发症的危险因素较多,应针对性地进行防治,改善患者预后.%Objective To investigate the risk factors of postoperative puhnonary complications in patients with liver cancer.Methods A total of 160 patients with liver caner underwent surgical treatment were selected as the subjects from Mar.2014 to Apr.2016 in Xijing Hospital,the First Affiliated Hospital of the Fourth Military Medical University.They were divided into observation group (pulmonary complications) and control group (without pulmonary complications) according to the pulmonary complications,the risk factors of postoperative pulmonary complications in patients were analyzed.Results The univariate analysis showed that age,smoking history,history of cerebrovascular accident,history of lung disease,surgical duration,intraoperative bleeding,postoperative mechanical ventilation,prophylactic use of antibiotics,application of postoperative analgesia pump were related to postoperative pulmonary infection in patients with liver cancer (P ＜ 0.05);multivariate Logistic analysis showed that the age of patients,pulmonary disease history,operation time and postoperative analgesia pump were independent risk factors of pulmonary infection in patients with liver cancer.Conclusion There are many risk factors for pulmonary complications in patients with liver cancer after surgical treatment.The measures should be taken to prevent,control,and improve the prognosis of patients.