摘要
目的探讨腹部外科术后发生急性呼吸衰竭的诱因及影响机械通气疗效的因素。方法回顾性分析91例患者腹部外科术后发生急性呼吸衰竭的基础疾病、诱因及机械通气治疗的效果。结果诱因包括术后发生肺部感染53例,严重腹腔感染或急性重症胰腺炎导致的急性呼吸窘迫综合征(ARDS)38例。其中合并慢性阻塞性肺病(COPD)38例,重度营养不良32例,低钾血症14例。呼吸衰竭发生在术后(4.08±2.45)d,机械通气维持时间(21.66±21.42)d。死亡33例(36.3%),撤机成功58例(63.7%)。结论腹部外科术后发生急性呼吸衰竭时,应合理实施机械通气并调整撤机策略,避免机械通气依赖。及时处理原发病,有效控制腹腔感染,积极进行对症与支持治疗是影响机械通气成败的因素。
Objective To explore the predisposing factors in the development of acute respiratory failure after abdominal surgery and the factors affecting the therapeutic effect of mechanical ventilation. Methods A retrospective study was undertaken for acute respiratory failure after abdominal surgery in 91 patients. The underline diseases, introducing causes and efficacy of mechanical ventilation were retrospectively analysed. Results Postoperative pneumonia was the cause of acute respiratory failure in 53 cases and ARDS caused by severe abdominal infection and severe acute pancreatitis in 38 cases. Of the 91 cases, complicated with COPD in 38 cases, severe malnutrion 32 cases, and hypokalemia 14 cases. Respiratory failure occurred at （4.08 ± 2.45 ） days after operation. The duration of mechanical ventilation was （ 21 . 66 ± 21 . 42 ） days ; 33 cases died, and 58 cases were successfully recovered with mechanical ventilation. Conclusions The management of acute respiratory failure after abdominal asurgery should be rational use of mechanical ventilation, adjustment of weaning strategy and avoidance of dependance on mechanical ventilation. Timely treatment of the primary disease, effective control of abdominal infection and aggressive symptomatic and supportive treatment are factors that affect the success or failure of mechanical ventilation.
出处
《中国普通外科杂志》
CAS
CSCD
2005年第8期605-607,共3页
China Journal of General Surgery
作者简介
丁士芳（1967-），男，山东平阴人，山东大学齐鲁医院主治医师，主要从事急危重病基础与临床方面的研究．通讯作者：丁士芳 电话：0531—8170548；E-mail：dingshifang@yahoo.com.cn.
