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支气管扩张症术后并发症危险因素分析
The Analysis of Risk Factors of Postoperative Complications in Patient with Bronchiectasis
【作者】 白涛；
【导师】 张铸；
【作者基本信息】 新疆医科大学 ， 外科学， 2011， 硕士
【摘要】 目的：总结新疆医科大学第一附属医院胸外科近8年支气管扩张症外科治疗经验,分析可能影响术后并发症的危险因素；方法：回顾分析新疆医科大学第一附属医院胸外科2002年4月至2010年10月102例行外科手术治疗的支气管扩张症患者的临床资料,选择性别、年龄、病程、吸烟史、结核病史、FEV1%、支扩类型、手术方式及胸膜粘连等9个因素,分析其与支气管胸膜瘘、脓胸、胸膜腔进行性出血、肺不张、肺炎等术后并发症的关系,采用Logistic回归分析处理资料；结果：102例支气管扩张症患者行105次手术,其中3例患者因胸腔进行性出血接受二次手术。平均年龄36.8岁,病史8个月至40年。并发症发生率为16.7%,无手术死亡病例。Logistic回归分析示：第一秒用力呼气容积低于60%(P=0.007)及胸膜粘连(P=0.011)为术后并发症的独立预测因素,差异均有统计学意义；结论：FEV1%较低及胸膜腔粘连为支气管扩张症术后并发症危险因素。术前加强呼吸道管理,及时控制肺部炎症,利于改善肺功能,减少胸膜腔粘连,降低术后并发症发生率。
【Abstract】 Objective:The purpose of this study is to summarize 8 years bronchiectasis s urgical treatment experience at the the First Affiliated Hospital of Xinjiang Medical University,Thoracic Surgery,and to analysis several factors that might affect postop erative complications of this disease;Methods:Retrospective analysis the medical re cords of 104 patients who underwent surgical treatment for bronchiectasis between April 2002 to October 2010 at Thoracic Surgery of the First Affiliated Hospital of Xinjiang Medical University,choosing nine factors,including gender、age、duration、smoking history、the history of tuberculosis、forced expiratory volume in the first s econds、branch expansion type、resection and pleural adhesions lesions.Analysis the relationship between these factors with postoperative complications,such as bronchial fistula、empyema,pleural cavity bleeding,atelectasis,pneumonia, and so on.Using Logi stic regression statistics method to analyze data;Results:102 patients underwent 105 operations for bronchiectasis,and three of them underwent the second operations.The mean age was 36.8 years old.The duration was between 8 months and 40 years.C omplication rate was 16.7%,with no deaths.Logistic regression analysis shows that t he first seconds forced expiratory volume (P=0.007) and pleural adhesions (P=0.01 1) were statistically significant;Conclusion:A low forced expiratory volume in 1 s econd and pleural cavity adhesion were risk factors for postoperative complications. Before surgery, strengthening the management of the respiratory and timely controll ing of lung inflammation can help to improve lung function,reduce the adhesion of the pleural cavity,and reduce the incidence of postoperative complications.