摘要
目的探讨肺切除术后发生肺不张的危险因素,为临床防治提供参考。方法回顾性分析本院196例行肺叶或亚肺叶切除术患者的临床资料,根据年龄、性别、吸烟史、术前肺功能、是否合并基础疾病、咳痰情况、术中单肺通气时间(One-lung ventilation,OLV)、手术方式、手术切除范围、抗生素使用情况对患者进行分组,对其差异性做Logistics分析。结果单因素分析显示肺切除术后并发肺不张与有无吸烟史、患者术前肺功能、是否合并基础病、患者咳痰情况、以及术中单肺通气时间有相关性(P<0.05),多因素Logistics分析显示患者的肺功能、是否合并基础疾病、咳痰情况以及术中单肺通气时间是肺部分切除术后患者并发肺不张的独立危险因素。结论肺切除术后发生肺不张的影响因素较多,临床实践中应充分评估患者的术前肺功能,积极治疗基础疾病,指导患者正确咳痰,缩短术中单肺通气时间以降低手术后肺不张的发生率,改善患者的预后。
Objective To explore the related factors of atelectasis after pneumoresection,and to provide reference for the clinical prevention and treatment. Methods The clinical data of 196 cases with pneumoresection were retrospectively analyzed,and all the cases were divided into different groups according to their age,gender,smoking history,preoperative pulmonary function,basic lung disease,expectoration capacity,the time of one-lung ventilation,surgical approach,resection range,and the usage of antibiotics. The differences were analyzed by logistics analysis. Results Univariate analysis showed that smoking history,preoperative pulmonary function,basic lung disease,expectoration capacity and the time of one-lung ventilation( OLV) were related with atelectasis after pneumoresection. Logistics multivariate regression showed that patients’ expectoration capacity,basic lung disease,expectoration capacity and the time of one-lung ventilation were independent risk factors for atelectasis after pneumoresection.Conclusion There are many risk factors of atelectasis after pneumoresection,and its incidence can be reduced by full appraisal of patients’ lung function,active treatment of basic lung disease,educating patients the right way of expectoration,and reducing the time of one-lung ventilation.
作者
许舜
姚锋锋
于奇
彭磊磊
陈梦苒
刘永靖
XU Shun;YAO Feng-feng;YU Qi;PENG Lei-lei;CHEN Meng-ran;LIU Yong-jing(the 105th Hospital of PLA Affiliated to Bengbu Medical College,Hefei,Anhui 230031,China)
出处
《临床肺科杂志》
2018年第1期46-49,共4页
Journal of Clinical Pulmonary Medicine
关键词
肺不张
肺切除术
危险因素
atelectasis
pneumoresection
risk factors
