高龄贲门癌患者术后呼吸衰竭的危险因素分析

目的 分析可能导致高龄贲门癌患者术后呼吸衰竭（RF）的因素.方法 分析高龄贲门癌术后发生RF 28例患者与同期术后未发生RF的56例患者的临床资料,比较两组术前肺功能,术前、术后合并症、手术方式、手术当天静脉液体人量、年龄、吸烟量的差异.进行单因素分析和多因素Logistic回归分析.结果 单因素分析显示最大通气量（MVV）〈50%、残气容量/肺总量（RV/LTC〉50%、第一秒用力呼气容积（FEV1）〈1.5 L、最大呼气流量（PEF）〈70%、75%肺活量最大呼气流量（V75）〈70%、肺一氧化碳弥散量（DLCO）〈80%、手术当天（含术中）静脉晶体入量和输血量、术后其并发症发生率、胸部切口,与术后RF有关.多因素Logistic回归分析发现MVV〈50%、RV/LTC：〉50%、FEV1〈1.5 L、DLCO〈80%是术后发生RF的危险因素.结论术前肺功能检查可预测术后RF的发生,也可采取预防措施减少RF的发生.

Analysis of the risk factors for post-operative respiratory failure in elderly cardiac carcinoma patients

Objective To analyze the risk factors of post-operative respiratory failure in elderly cardiac carcinoma patients.Methods 28 elderly patients with respiratory failure (respiratory failure group) after the resection of cardiac carcinoma and 56 controls (control group) were studied.Preoperative respiratory function,the other complications,the site of incision,intravenous infusion,age of patients and smoking between two groups were compared by Logistic regression.Results Univariate risk factors included MVV<50% ,RV/TLC>50% ,FEV1<1.5L,PEF<70% ,DLCO<80% ,V75<70% ,the venous input,incision at chest.Multivariate logistic regression analysis identified that MVV<50% ,RV/TLC>50% ,FEV,<1.5 L,DLCO<80% were risk factors.Conclusion These results suggested that the patients with risk factors described above need more careful pre and post operative surveillance and management.