517例瓣膜置换术后发生肺不张的危险因素分析

目的分析瓣膜置换术后肺不张的危险因素,为临床选择治疗方法和评估预后提供依据。方法将我院1998年1月至2005年10月完成的517例瓣膜置换术患者按有无肺不张分成两组,进行单因素分析和多因素Logistic回归分析。结果全组有肺不张31例,单因素显著性分析发现年龄、吸烟史、左心房直径、术前肺动脉高压、体外循环时间、主动脉阻断时间、胸膜完整、使用膜肺以及应用药物和长期应用呼吸机有相关性;多因素Logistic回归分析结果显示高龄、体外循环时间、联合瓣膜病等是独立的相关危险因素。结论瓣摸置换术后肺不张与多种因素有关,临床应引起高度重视。

Clinical complications analysis of atelectasis after cardiac valve replacement

Objective To analyze the risk factors of atelectasis after cardiac valve replace-ment and to supply a proof for clinic therapy and assessment of prognosis .Methods Data of 517 patients undergoing cardiac valve replacement in our hospital between January 1998 and October 2005 werecollected .Preoperative and operative variates were evaluated by unatelectasis and atelectasis and multivari-atelogistic stepwise regression analysis .Results There were 31 patients of atelectasis .Univariate riskfactorsincluded age ,smoking history ,diameter of left atria ,pul monary arteryhypertension before surgery ,cardiopul monary bypass ti me ,aortic cross -clampingti me ,pleuraintegrality ,using Membrane Oxygenatorand medcine ,ventilator for longterm.Logistic stepwise regression analysis showed that old age,smoking,cardiopul monary bypass ti me ,combinedlesions of valves were independent risk factors of atelectasis aftercardiac valve replacement .Conclusion Atelectasis after valve replacement is veryi mportant .