食管癌术后呼吸衰竭的相关危险因素分析及预防措施

  目的  探讨食管癌术后发生呼吸衰竭的相关危险因素。  方法  应用Logistic逐步回归分析法对新乡市中心医院在2005年1月至2010年6月期间, 食管癌术后发生呼吸衰竭的63例患者与63例术后未发生呼吸衰竭者经行病例一对照分析。  结果  肺部疾病史、吸烟、肺功能损坏、手术时间、管状胃、术后并发症及术前心脏疾病这7个相关因素与术后呼吸衰竭的发生有显著关系, 其中管状胃为保护性因素(β < 0);对病例组进行分析发现术前肺功能中度或重度损害、有基础肺疾病、插管及呼吸机使用时间较长、术后出现相关并发症者, 其术后发生呼吸衰竭且死亡风险明显增加(P < 0.05)。  结论  重视对呼吸衰竭危险因素的防治可有效减少呼吸衰竭的发生。 

Associated Risk Factor Analysis and Preventive Measures of Respiratory Failure after Esophagectomy

  Objective  The present paper discusses the related risk factors of respiratory failure after esophagectomy.  Methods  Logistic stepwise regression analysis was used to conduct a case control analysis of the medical records of 63 patients with respiratory failure after esophagectomy, as well as another 63 postoperative patients without failure in the First Department of Thoracic Oncology, Xinxiang Central Hospital, between January 2007 and June 2010.  Results  Pulmonary disease history, smoking, impairment of lung function, operating time, tubular stomach, postoperative complications, and preoperative heart diseases showed a significant correlation with postoperative respiratory failure. Among the aforementioned factors, the tubular stomach is considered the protective factor (β < 0). After the analysis of the case group, the death risk for respiratory failure obviously increased in patients with preoperative moderate or severe impairment of lung function, basic pulmonary disease, long-time use of the tracheal intubation and breathing machine, and related postoperative complications (P < 0.05).  Conclusion  A focus on the prevention and control of risk factors can effectively reduce the occurrence of the respiratory failure.