血管腔内修复术患者术后并发症的术前危险因素分析

 目的 分析血管腔内修复术患者的术后并发症,筛选出相关术前危险因素,为促进患者术后康复提供参考。方法 回顾性分析复旦大学附属中山医院血管外科2013年1月至2014年12月收治的2 896例择期血管腔内修复术患者的临床资料,筛选与手术后各种并发症相关的术前危险因素。结果 共148例患者发生了术后并发症,包括住院期间2例死亡。年龄＞75岁的患者,术前合并高血压病、糖尿病、肾功能不全、慢性阻塞性肺病(chronic obstructive pulmonary disease, COPD)病史的患者和ASA分级＞Ⅱ级的患者并发症发生率分别为9.7%、8.1%、14.3%、8.0%、29.7%和6.3%。多因素Logistic回归分析显示:年龄＞75岁,术前合并高血压病、糖尿病、肾功能不全、COPD病史和ASA分级＞Ⅱ级均是血管外科腔内修复术后并发症的独立危险因素,优势比(odds ratio, OR)分别为43.29(95%CI:22.51～83.28,P=0.000)、3.822(95%CI:2.37～6.16,P=0.000)、1.714(95%CI:1.07～2.75,P=0.025)、2.692(95%CI:1.19～6.07,P=0.017)、7.158(95%CI:3.83～13.37,P=0.000)和27.77(95%CI:13.79～55.93,P=0.000)。结论 年龄＞75岁,术前合并高血压病、糖尿病、肾功能不全、COPD病史和ASA分级大于Ⅱ级均是血管腔内修复术后并发症的独立危险因素。

Analysis of preoperative risk factors of postoperative complications in patients undergoing endovascular repair surgery

Objective To summarize the perioperative outcomes of patients undergoing endovascular repair, and to screen out related preoperative risk factors in order to provide reference for the promotion of postoperative rehabilitation of patients. Methods The clinical data of 2 896 patients undergoing elective endovascular repair in the Department of Vascular Surgery, Zhongshan Hospital, Fudan University from Jan. 2013 to Dec. 2014 were analyzed to screen out related preoperative risk factors of postoperative complications retrospectively. Results A total of 148 patients had postoperative complications, including 2 cases of death during hospitalization. The incidence of complications in the patients older than 75 years old, with hypertension, diabetic mellitus, renal dysfunction, chronic obstructive pulmonary disease (COPD) or ASA physical status more than grade Ⅱ is 9.7%, 8.1%, 14.3%, 8.0%, 29.7%, 6.3%, respectively. The multivariate Logistic regression analysis identified that patients older than 75 years old (P=0.000, OR=43.29, 95%CI: 22.51-83.28), with hypertension (P=0.000, OR=3.822, 95%CI: 2.37-6.16), diabetic mellitus (P=0.025, OR=1.714, 95%CI: 1.07-2.75), renal dysfunction (P=0.017, OR=2.692, 95%CI: 1.19-6.07) or COPD (P=0.000, OR=7.158, 95%CI: 3.83-13.37) and ASA physical status more than grade Ⅱ (P=0.000, OR=27.77, 95%CI: 13.79-55.93) were the independent risk factors with postoperative complications of endovascular repair surgery. Conclusions The patients older than 75 years old,with hypertension, diabetic mellitus, renal dysfunction or COPD and ASA physical status more than grade Ⅱ were the independent risk factors for endovascular repair surgery.