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目的:探讨伴慢性阻塞性肺疾病（COPD）稳定期术后患者入重症监护病房（ICU）的风险。方法:选择2014年3月至2020年12月中国医科大学附属盛京医院收治的拟行外科手术的COPD稳定期患者。基于慢性阻塞性肺疾病全球倡议（GOLD）指南标准，按照术前气流受限程度分为1级〔第1秒用力呼气容积占预计值百分比（FEV1%）≥80%〕、2级（50%≤FEV1%<80%）、3级（30%≤FEV1%<50%）、4级（FEV1%<30%）；基于2021年修订版COPD诊治指南，结合患者症状水平和1年内中、重度急性加重史分为A、B、C、D 4组，其中A组症状最轻、急性加重频率最低且程度最轻，D组症状最重、急性加重最频繁且程度最重。收集患者的一般资料、COPD相关因素、手术相关因素以及术后入ICU的情况，分析术前不同程度气流受限及不同症状综合评估与术后入ICU风险的关系；采用多因素Logistic回归模型分析影响术后入ICU的危险因素。结果:共143例患者纳入分析，根据气流受限程度，GOLD 1级34例、2级72例、3级32例、4级5例；根据症状综合评估，A组78例、B组31例、C组5例、D组29例。不同程度气流受限各组及不同症状综合评估各组间患者的性别、年龄、身高、体质量等一般资料比较差异均无统计学意义。单因素分析显示，术前气流受限程度和症状综合评估与术后入ICU并不相关〔气流受限程度：优势比（n OR）＝1.526，95%可信区间（95%n CI）为0.682~3.415，n P＝0.304；症状综合评估：n OR＝1.508，95%n CI为0.921~2.469，n P＝0.103〕。不同程度气流受限各组及不同症状综合评估各组间患者手术部位、手术方式、麻醉方式和手术时间等手术相关因素比较差异均无统计学意义。143例患者中，10例术后入ICU，133例未入ICU。入ICU组患者比未入ICU组年龄更大（岁：73.10±10.56比65.14±9.79，n P<0.05），呼吸困难指数分级更高〔mMRC分级（级）：1.5（1.0，2.0）比1.0（0，2.0），n P<0.05〕，每年急性加重频率更高〔次：1（1，2）比0（0，1），n P<0.05〕，且两组患者手术方式差异也有统计学意义。多因素Logistic回归分析结果显示，年龄以及每年急性加重频率是术后入ICU的独立危险因素（年龄：n OR＝1.093，95%n CI为1.010~1.183，n P＝0.028；每年急性加重频率：n OR＝2.400，95%n CI为1.015~5.676，n P＝0.046）。n 结论:伴COPD稳定期患者术前气流受限程度和症状综合评估与术后入ICU风险无关；年龄及每年急性加重频率为伴COPD稳定期术后患者入ICU的危险因素。“,”Objective:To observe the risk factors of intensive care unit (ICU) admission for postoperative patients with stable chronic obstructive pulmonary disease (COPD).Methods:Patients with stable COPD who were admitted to Shengjing Hospital of China Medical University for proposed surgical procedures from March 2014 to December 2020 were enrolled. Based on the criteria of the global initiative for chronic obstructive lung disease (GOLD), the patients were classified according to the severity of airflow limitation as grade 1 [forced expiratory volume in one second as a percentage of expected value (FEV1%) ≥ 80%], grade 2 (50% ≤ FEV1% < 80%), grade 3 (30% ≤ FEV1% < 50%), and grade 4 (FEV1% < 30%). Then the patients were divided into groups A, B, C, D according to symptom level and history of moderate/severe acute exacerbation within 1 year. The patients in the group A had the lightest symptoms, the lowest frequency and degree of acute exacerbation, while those in the group D had the most severe symptoms, the most frequent and degree of acute exacerbation. Data of general information, COPD-related factors, surgical-related factors and postoperative admission to ICU were collected. The correlation between different degree of airflow limitation subgroups as well as different comprehensive assessment of symptom subgroups and risk of postoperative ICU admission was analyzed. Multivariate Logistic regression models were used to analyze the risk factors affecting postoperative ICU admission.Results:A total of 143 patients were enrolled in the analysis. According to the degree of airflow limitation, there were 34 patients in GOLD grade 1, 72 in grade 2, 32 in grade 3 and 5 in grade 4. According to the comprehensive assessment of symptoms, there were 78 patients in group A, 31 in group B, 5 in group C and 29 in group D. There were no statistically significant differences in the general data of gender, age, height and weight of patients in each group with different degrees of airflow limitation and different comprehensive assessment of symptoms. Univariate analysis showed that the degree of airflow limitation and comprehensive assessment of symptoms were not associated with postoperative ICU admission [degree of airflow limitation: odds ratio (n OR) = 1.526, 95% confidence interval (95%n CI) was 0.682-3.415, n P = 0.304; comprehensive assessment of symptoms: n OR = 1.508, 95%n CI was 0.921-2.469, n P = 0.103]. There was also no statistically significant difference in the surgical-related factors such as surgical site, surgical method, anesthesia, and surgical duration among the patients with different degrees of airflow limitation and different comprehensive assessment of symptoms. Among the 143 patients, 10 were admitted to ICU postoperation and 133 were not. Compared with the non-admitted ICU patients, patients admitted ICU were older (years old: 73.10±10.56 vs. 65.14±9.79, n P < 0.05), had a higher modified Medical Research Council (mMRC) classification [1.5 (1.0, 2.0) vs. 1.0 (0, 2.0), n P < 0.05], and had more frequent acute exacerbations per year [times: 1 (1, 2) vs. 1 (0, 1), n P < 0.05]. There was also significant difference in surgical method between the two. Multivariate Logistic regression analysis showed that age and frequency of acute exacerbations per year were risk factors for postoperative admission to the ICU (age: n OR = 1.093, 95%n CI was 1.010-1.183, n P = 0.028; frequency of acute exacerbations per year: n OR = 2.400, 95%n CI was 1.015-5.676, n P = 0.046).n Conclusions:Different levels of airflow restriction and symptom comprehensive assessment groupings in stable COPD patients are not associated with the risk of postoperative ICU admission. Age and frequency of acute exacerbations per year were risk factors for postoperative ICU admission.