论文部分内容阅读
目的探讨肺切除术后急性呼吸衰竭(ARF)的危险因素及护理策略。方法选择2015年4月—2016年2月间杭州师范大学附属医院收治的88例肺切除术患者,依据患者术后是否发生急性呼吸衰竭,将患者分为呼吸衰竭组和无呼吸衰竭组。收集2组患者的基本资料,包括:患者一般资料(性别、年龄、吸烟指数、心血管病史)、术前肺功能[用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、最大通气量(MVV)、用力呼气量占用力肺活量比值(FEV1/FVC)]、手术方式(部分肺切除、全肺切除)、补液量(术中补液量、术后当天补液量),采用单因素和Logistic回归分析对收集的数据资料进行分析。结果患者肺切除术后急性呼吸衰竭的发生率为31.8%。单因素和Logistic回归分析发现年龄、吸烟指数、心血管病史、FVC<1.8 L、FEV1<1.5 L、FEV1/FVC<70%、手术方式、术中补液量、术后当天补液量是肺切除患者术后发生急性呼吸衰竭的危险因素。结论肺切除患者术后易发生急性呼吸衰竭,年龄、吸烟指数、心血管病史、FVC<1.8 L、FEV1<1.5 L、FEV1/FVC<70%、手术方式、术中补液量、术后当天补液量是肺切除患者术后发生急性呼吸衰竭的危险因素,临床工作中要重视发生ARF的危险因素,做好预防和治疗工作。
Objective To investigate the risk factors and nursing strategies of acute respiratory failure (ARF) after pneumonectomy. Methods Eighty-eight patients undergoing pneumonectomy were enrolled in the Affiliated Hospital of Hangzhou Normal University between April 2015 and February 2016. Patients were divided into respiratory failure group and non-respiratory failure group according to whether they had acute respiratory failure after operation. General information about the patients (gender, age, smoking index, cardiovascular history), preoperative pulmonary function (FVC), forced expiratory volume in 1 second (FEV 1), maximal ventilation MVV, FEV1 / FVC], operation mode (partial pneumonectomy, pneumonectomy), fluid volume (intraoperative fluid volume, fluid volume on the day after surgery), single factor And Logistic regression analysis of the data collected. Results The incidence of acute respiratory failure after pneumonectomy was 31.8%. Univariate and logistic regression analysis found that age, smoking index, history of cardiovascular disease, FVC <1.8 L, FEV1 <1.5 L, FEV1 / FVC <70%, surgical methods, intraoperative fluid volume, Postoperative risk factors for acute respiratory failure. Conclusions Patients with pneumonectomy are prone to acute respiratory failure, age, smoking index, history of cardiovascular disease, FVC <1.8 L, FEV1 <1.5 L, FEV1 / FVC <70%, operation mode, intraoperative fluid volume, The amount of lung resection is the risk of acute respiratory failure in patients with risk factors, clinical work should pay attention to the occurrence of ARF risk factors, prevention and treatment work.