食管癌术后并发症危险因素的Logistic分析及护理干预

目的探讨食管癌术后并发症的常见类型和危险因素，为并发症的预防提供有效的护理对策。方法回顾性分析142例经手术治疗的食管癌患者，统计并发症发生的类型和发生率，对危险因素采用单因素Х^2检验和多因素Logistic回归分析。结果食管癌术后并发症发生率为32．4％，其中肺部并发症发生率为21．1％。结果显示接受放化疗（OR=1．438，95％CI1．231～1．690）、吸烟（OR=2．152，95％CI1．756-2．637）、烟龄（OR=2．447，95％CI1．683～3．558）、营养不良（OR=1．930，95％CI1．756～2．121）、合并肺部疾病（OR=2．251，95％CI1．850—2．739）和手术时间（OR=2．550，95％CI1．989～3．269）是并发症发生的危险因素（P〈0．05），而胸腹腔镜手术（OR=0．436，95％CI0．313～0．607）是并发症发生的保护因素（P〈0．05）。结论食管癌术后并发症的发生率很高，并且与患者的基础特征、手术、营养等多种因素有关，必须根据相关危险因素实施有针对性的护理工作，以彻底地预防和降低并发症的发生。

Logistic regressive analysis of risk factors for postoperative complications and nursing intervention of esophageal carcinoma

Objective To explore the categories of postoperative complications and risk factors of esophageal carcinoma, which may help establish effective nursing strategies for prevention of complications. Methods We did a retrospective analysis on the clinical profiles of 142 patients with esophageal carcinoma who underwent surgery. This entailed the determination of the categories, the incidence of postoperative complications and the risk factors via uni- variate Х^2 tests and multivariate Logistic regression analysis. Results The incidence of postoperative complications was 32.4%, of which the incidence of pulmonary complication was 21.1%. Multivariate analysis showed that radio- chemical therapy （OR=1.438, 95%CI： 1.231-1.690）, smoking （OR=2.152, 95%CI： 1.756-2.637）, the number of years of smoking （OR=2.447, 95%CI： 1.683-3.558）, malnutrition （OR=1.930, 95%C1： 1.756-2.121）, complication with pul- monary diseases （OR=2.251, 95%CI： 1.850-2.739） and the duration of operation （OR=2.550, 95%CI： 1.989-3.269） were the risk factors for complications. Whereas the chest laparoscopic surgery was a protective factor （OR=0.436, 95%CI： 0.313-0.607）. Conclusion The incidence of postoperative complications is high in patients with esophageal carcinoma and is related to patient＇s characteristics, the mode of surgery and nutritional status. This warrants targeted nursing strategies in accordance with the risk factors, which may achieve a thorough prevention and reduction of the incidence of postoperative complications.