食管癌术后吸入性肺炎合并急性呼吸窘迫综合征的预后高危因素分析
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摘要
目的探究食管癌术后吸入性肺炎合并急性呼吸窘迫综合征患者预后的高危因素。方法选取79例食管癌术后吸入性肺炎合并急性呼吸窘迫综合征患者为研究对象,将其中的存活率与死亡率进行统计,并将其中不同基本情况(性别、年龄、心率、呼吸及氧合指数)和疾病治疗情况(吻合口瘘、MODS发生情况、呼吸困难病程、手术方式及TNM分期)患者的死亡率与存活率进行比较,同时采用Logistic分析处理上述因素与此类患者预后的关系。结果 79例死亡29例(36.71%),其中不同性别患者的死亡率无显著性差异(P>0.05),而其他不同基本情况和疾病治疗情况患者的死亡率则存在显著性差异。经Logistic显示,年龄、心率、呼吸及氧合指数、吻合口瘘、MODS发生情况、呼吸困难病程、手术方式及TNM分期均是此类患者死亡的高危因素(P<0.05)。结论食管癌术后吸入性肺炎合并急性呼吸窘迫综合征患者的预后较差,且受多种高危因素影响,应根据其危险因素给予针对性干预。
Objective To analyze the prognostic high risk factors of patients with aspiration pneumonia complicated with acute respiratory distress syndrome after esophageal cancer operation. Methods 79 patients with aspiration pneumonia complicated with acute respiratory distress syndrome after esophageal cancer operation were selected,and the survival rate and mortality of the patients were analyzed,and the survival rate and mortality of patients with different basic situation( gender,ages,heart rate,respiration and oxygenation index),disease and treatment situation( anastomotic leakage,MODS,dyspnea course,surgical modes and TNM stages) were compared,and the relationship between those factors and prognosis of theses patients were ananlyzed with Logistic analysis. Results The mortality of 79 patients with aspiration pneumonia complicated with acute respiratory distress syndrome after esophageal cancer operation was higher,and the mortality of patients with different gender had no significant difference,P > 0. 05,while the mortality of patients with other basic situation,disease and treatment situation had significant differences,and the Logisticanalysis showed those factors were all the high risk factors of these patients for death,all P < 0. 05. Conclusion The prognosis of of patients with aspiration pneumonia complicated with acute respiratory distress syndrome after esophageal cancer operation is worse,and the ages,heart rate,respiration,oxygenation index,anastomotic leakage,MODS,dyspnea course,surgical modes and TNM stages are all the high risk factors,so they should receive targeted intervention.
Objective To analyze the prognostic high risk factors of patients with aspiration pneumonia complicated with acute respiratory distress syndrome after esophageal cancer operation. Methods 79 patients with aspiration pneumonia complicated with acute respiratory distress syndrome after esophageal cancer operation were selected,and the survival rate and mortality of the patients were analyzed,and the survival rate and mortality of patients with different basic situation( gender,ages,heart rate,respiration and oxygenation index),disease and treatment situation( anastomotic leakage,MODS,dyspnea course,surgical modes and TNM stages) were compared,and the relationship between those factors and prognosis of theses patients were ananlyzed with Logistic analysis. Results The mortality of 79 patients with aspiration pneumonia complicated with acute respiratory distress syndrome after esophageal cancer operation was higher,and the mortality of patients with different gender had no significant difference,P > 0. 05,while the mortality of patients with other basic situation,disease and treatment situation had significant differences,and the Logisticanalysis showed those factors were all the high risk factors of these patients for death,all P < 0. 05. Conclusion The prognosis of of patients with aspiration pneumonia complicated with acute respiratory distress syndrome after esophageal cancer operation is worse,and the ages,heart rate,respiration,oxygenation index,anastomotic leakage,MODS,dyspnea course,surgical modes and TNM stages are all the high risk factors,so they should receive targeted intervention.
引文
[1]冼燕珊,周立新,莫韶妹,等.急性呼吸窘迫综合征机械通气并发气胸的高危因素分析[J].现代诊断与治疗,2015,26(17):3998-4000.
[2]罗守刚.重症胸外伤并发致急性呼吸窘迫综合征的高危因素分析[J].现代诊断与治疗,2015,26(10):2347-2348.
[3]陈耀武.重症胸外伤并发急性呼吸窘迫综合征的高危因素分析[J].中外医疗,2013,32(4):109-110.
[4]郑新阳,林建生,施海展,等.食管癌术后急性呼吸衰竭的高危因素[J].中外医学研究,2016,14(20):53-54.
[5]乐静鸿.食管癌术后呼吸衰竭高危因素分析及对策[J].现代中西医结合杂志,2013,22(30):3366-3368.
[6]郑晓峰,张鑫.食管癌术后肺部感染的危险因素及临床药师对抗生素选择的干预效果[J].现代中西医结合杂志,2015,24(12):1298-1300.
[7]黄明芳,刘德森,潘琪,等.食管癌术后肺部并发症的危险因素分析859例[J].世界华人消化杂志,2014,22(12):1703-1708.
[8]方岩,张铸,张昌明,等.食管癌术后发生呼吸衰竭的危险因素[J].新乡医学院学报,2013,30(6):466-469.
[9]图尔霍·麦图松,张昌明,朱辉.食管癌切除术后围术期死亡危险因素的分析及预测模型的建立[J].世界华人消化杂志,2016,24(24):3587-3597.
[10]吴伟,王可兵,史冬森,等.食管癌术后肺部并发症的患者相关危险因素分析[J].临床肺科杂志,2015,20(7):1186-1188.
[11]Yoshida N,Tamaoki Y,Baba Y,et al.Incidence and risk factors of synchronous colorectal cancer in patients with esophageal cancer:an analysis of 480 consecutive colonoscopies before surgery[J].Int J Clin Oncol,2016,21(6):1079-1084.
[12]闵晓松,申宝庆.食管癌术后伴发呼吸系统并发症相关危险因素临床分析[J].中国现代医学杂志,2013,23(28):72-75.
[13]Chen YF,Li Q,Chen DT,et al.Prognostic value of pre-operative serum uric acid levels in esophageal squamous cell carcinoma patients who undergo R0 esophagectomy[J].Cancer Biomark,2016,17(1):89-96.
[14]林桂芬,王峰,俞峥,等.食管癌术后吸入性肺炎合并急性呼吸窘迫综合征的预后高危因素分析[J].实用临床医药杂志,2015,19(23):62-65.
[15]杨泽山.431例老年食管癌患者术后肺部并发症情况及危险因素分析[J].中华全科医学,2015,13(11):1779-1781.
[2]罗守刚.重症胸外伤并发致急性呼吸窘迫综合征的高危因素分析[J].现代诊断与治疗,2015,26(10):2347-2348.
[3]陈耀武.重症胸外伤并发急性呼吸窘迫综合征的高危因素分析[J].中外医疗,2013,32(4):109-110.
[4]郑新阳,林建生,施海展,等.食管癌术后急性呼吸衰竭的高危因素[J].中外医学研究,2016,14(20):53-54.
[5]乐静鸿.食管癌术后呼吸衰竭高危因素分析及对策[J].现代中西医结合杂志,2013,22(30):3366-3368.
[6]郑晓峰,张鑫.食管癌术后肺部感染的危险因素及临床药师对抗生素选择的干预效果[J].现代中西医结合杂志,2015,24(12):1298-1300.
[7]黄明芳,刘德森,潘琪,等.食管癌术后肺部并发症的危险因素分析859例[J].世界华人消化杂志,2014,22(12):1703-1708.
[8]方岩,张铸,张昌明,等.食管癌术后发生呼吸衰竭的危险因素[J].新乡医学院学报,2013,30(6):466-469.
[9]图尔霍·麦图松,张昌明,朱辉.食管癌切除术后围术期死亡危险因素的分析及预测模型的建立[J].世界华人消化杂志,2016,24(24):3587-3597.
[10]吴伟,王可兵,史冬森,等.食管癌术后肺部并发症的患者相关危险因素分析[J].临床肺科杂志,2015,20(7):1186-1188.
[11]Yoshida N,Tamaoki Y,Baba Y,et al.Incidence and risk factors of synchronous colorectal cancer in patients with esophageal cancer:an analysis of 480 consecutive colonoscopies before surgery[J].Int J Clin Oncol,2016,21(6):1079-1084.
[12]闵晓松,申宝庆.食管癌术后伴发呼吸系统并发症相关危险因素临床分析[J].中国现代医学杂志,2013,23(28):72-75.
[13]Chen YF,Li Q,Chen DT,et al.Prognostic value of pre-operative serum uric acid levels in esophageal squamous cell carcinoma patients who undergo R0 esophagectomy[J].Cancer Biomark,2016,17(1):89-96.
[14]林桂芬,王峰,俞峥,等.食管癌术后吸入性肺炎合并急性呼吸窘迫综合征的预后高危因素分析[J].实用临床医药杂志,2015,19(23):62-65.
[15]杨泽山.431例老年食管癌患者术后肺部并发症情况及危险因素分析[J].中华全科医学,2015,13(11):1779-1781.