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目的分析肺癌患者手术后并发呼吸功能衰竭的危险因素,为临床防治提供参考。方法选取34例本院收治的肺癌术后并发呼吸功能衰竭患者为研究对象和同时期术后未并发呼吸功能衰竭的肺癌患者68例为对照组,比较两组患者年龄、吸烟量、血浆白蛋白含量、既往呼吸系统疾病史、术前肺功能指标、术中出血量、术中输液量、术后当日输液量以及术后当日净入量等相关因素。结果观察组患者年龄、吸烟量大于对照组,比较差异有统计学意义(P<0.05);观察组患者术前血浆白蛋白量与对照组比较,差异无统计学意义(P>0.05);观察组既往呼吸系统疾病史患者所占比例为32.35%,高于对照组(2.94%),差异有统计学意义(P<0.05)。观察组患者用力肺活量(FVC)为(2.01±0.89)L,低于对照组[(2.67±1.31)L],差异有统计学意义(P<0.05);观察组患者第1 s用力呼气肺容积(FEV1)为(1.38±0.57)L,低于对照组[(2.27±0.81)L],差异有统计学意义(P<0.05);观察组患者FEV1/FVC(<70%)、FEF50%(<70%)比例高于对照组,比较差异有统计学意义(P<0.05);观察组患者FIF50%(<70%)、MVV(<50%)、IC(<70%)、ERV(<70%)与对照组比较,差异无统计学意义(P>0.05)。观察组患者术中出血量、术中输液量、术后当日输液量以及术后当日净入量均大于对照组,比较差异有统计学意义(P<0.05)。二项分类Logistic回归分析结果表明,患者年龄、既往呼吸道疾病史、用力肺活量(FVC)、第1 s用力呼气肺容积(FEV1)以及术后当日净入量是肺癌术后并发呼吸功能衰竭的危险因素(P<0.05)。结论老年患者、术前合并呼吸道疾病史,术前肺功能检查发现用力肺活量(FVC)和第1 s用力呼气肺容积(FEV1)降低以及术后液体入量过多均是肺癌患者肺切除术后并发急性呼吸功能衰竭的主要危险因素。
Objective To analyze the risk factors of respiratory failure after operation in patients with lung cancer and provide reference for clinical prevention and treatment. Methods Totally 68 patients with lung cancer who underwent lung cancer postoperative respiratory failure who were treated in our hospital were selected as the research object and 68 patients without concurrent respiratory failure during the same period as the control group. The age, smoking amount, plasma albumin Content, history of previous respiratory diseases, preoperative pulmonary function indicators, intraoperative blood loss, intraoperative fluid volume, intraoperative fluid volume and postoperative day net input and other related factors. Results The age and smoking amount of the observation group were significantly higher than those of the control group (P <0.05). There was no significant difference in the preoperative plasma albumin level between the observation group and the control group (P> 0.05) The proportion of patients with previous history of respiratory diseases was 32.35%, higher than that of control group (2.94%), the difference was statistically significant (P <0.05). The forced vital capacity (FVC) in the observation group was (2.01 ± 0.89) L, lower than that in the control group [(2.67 ± 1.31) L], the difference was statistically significant (P <0.05) (FEV1) was (1.38 ± 0.57) L, lower than the control group [(2.27 ± 0.81) L], the difference was statistically significant (P0.05); the FEV1 / FVC (<50%), ICV (<70%), ERV (<70%) in the observation group were significantly higher than those in the control group (P <0.05) <70%) compared with the control group, the difference was not statistically significant (P> 0.05). The intraoperative blood loss, intraoperative infusion volume, transfusion volume on the day after surgery, and the net amount on the day after surgery in the observation group were significantly larger than those in the control group (P <0.05). Logistic regression analysis showed that the age of patients, history of previous respiratory diseases, forced vital capacity (FVC), forced expiratory volume of 1 s (FEV1), and the net amount on the day after surgery were postoperative respiratory failure after lung cancer Risk factors (P <0.05). Conclusions Elderly patients, preoperative respiratory disease history, preoperative pulmonary function tests found that forced vital capacity (FVC) and forced expiratory volume of 1 s (FEV1) decreased and excessive fluid intake are lung cancer patients after lung resection After the concurrent acute respiratory failure of the main risk factors.