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目的探讨导致肺结核术后早期呼吸衰竭、住院死亡的危险因素。方法回顾性收集2002年1月—2007年12月北京胸科医院肺结核行肺切除手术患者302例,术后早期发生呼吸衰竭19例作为观察组(呼衰组),未发生呼吸衰竭的283例采用随机抽样的方法选取病例共35例作为对照组(非呼衰组),比较2组各项观察指标,行单因素分析,有统计学意义的各项指标进行多因素分析,以发现肺结核术后早期发生呼吸衰竭的危险因素,并比较2组的死亡率、平均住院时间。结果302例肺结核术后患者中,19例早期发生呼吸衰竭,占手术患者的6.3%(19/302),多因素分析,年龄和手术方式是肺结核肺切除患者术后早期发生呼吸衰竭的危险因素。2组比较,术后呼吸衰竭患者的病死率明显增加,平均住院时间延长,住院费用明显增加。结论年龄的增加,手术范围的扩大增加了肺结核肺切除患者术后发生呼吸衰竭的危险,术后呼吸衰竭在增加了患者术后病死率的同时,使患者平均住院时间延长,住院费用增加。
Objective To explore the risk factors of early postoperative respiratory failure and in-hospital mortality after pulmonary tuberculosis. Methods A total of 302 patients with pulmonary tuberculosis who underwent pulmonary tuberculosis in Beijing Chest Hospital from January 2002 to December 2007 were retrospectively studied. Among them, 19 cases of early respiratory failure occurred in the observation group (respiratory failure group) and 283 cases of respiratory failure A total of 35 cases were selected as the control group (non-respiratory failure group) by random sampling method. The two groups of observation indicators were compared. Univariate analysis, statistically significant indicators were analyzed by multivariate analysis to find that pulmonary tuberculosis The risk factors of respiratory failure occurred early afterwards, and the mortality and average length of stay in two groups were compared. Results Of the 302 patients with post-tuberculosis, 19 patients had early respiratory failure, accounting for 6.3% (19/302) of the patients undergoing surgery. Multivariate analysis, age and surgical modality were the risk factors for early postoperative respiratory failure in patients with pulmonary tuberculosis . Comparing the two groups, the mortality of postoperative patients with respiratory failure increased significantly, the average length of hospital stay, hospital costs increased significantly. Conclusion The increase of age and the expansion of operative scope increase the risk of postoperative respiratory failure in patients with pulmonary tuberculosis. Postoperative respiratory failure increases the postoperative mortality and prolongs the average length of stay and costs of hospitalization.