儿童肺包虫病术后并发症及复发的影响因素分析-外科学(胸外科)专业论文.docxVIP

儿童肺包虫病术后并发症及复发的影响因素分析 研究生：韩诚 导师：张昌明 副教授 摘 要 目的：探讨儿童肺包虫病术后并发症及复发的相关因素。方法：对我科 1957 年 6 月至 2008 年 12 月收治的 203 例肺包虫病患儿的临床表现、诊治情况、预后、复 发情况进行回顾性分析。通过文献报道及临床经验，选择了 8 个主要影响该病的术 后并发症及复发的因素，应用 SPSS 16.0 软件统计，对所选择的二分类资料采用χ2 检验进行单因素分析，采用二分类 Logistic 回归方程进行多因素分析。结果：所有患 儿均经手术治疗痊愈或好转出院，无死亡病例。术后并发肺部感染 17 例，切口感染 7 例，胆汁-胸膜瘘 1 例，并发症发生率 10.87 %(25/203)。术后随访 1-10 年，随访率 为 80.3% (163 /203)，12 例复发，复发率 5.9 %(12/203)。单因素统计分析结果表明胸 痛、咳包虫内囊皮、肺囊肿性质、囊肿破裂、术式、术前合并症对该病的术后并发 症有影响；咳包虫内囊皮、肺囊肿性质、囊肿破裂、术式、术前合并症对该病的术 后复发有影响。多因素 Logistic 回归分析结果表明咳包虫内囊皮、肺囊肿性质、囊肿 破裂、术前合并症是影响术后并发症发生的主要危险因素；咳包虫内囊皮、囊肿破 裂、术前合并症是影响复发的主要危险因素。结论：儿童肺包虫患者术后并发症发 生的主要危险因素为：咳包虫内囊皮、肺囊肿性质、囊肿破裂、术前合并症；术后 复发的主要危险因素为：咳包虫内囊皮、囊肿破裂、术前合并症。 关键词：儿童；肺包虫病；Logistic回归分析；危险因素 The analysis of influence factors about postoperative complications and relapse of children with pulmonary Echinococcus Postgraduate: Han cheng Supervisor: Associate Professor：Zhang Changming Abstract Objective: To approach the correlative factors about postoperative complications and relapse of children with pulmonary echinococcus. Methods: Retrospective analysis of 203 child patients with pulmonary echinococcus diagnosed in our department from June 1957 to December 2008 was carried out, associated with clinical manifestations, diagnosis and treatment, prognosis, recurrence. Via the literature search and clinical experiences, we chose 8 main factors influencing postoperative complications and relapse, and used x2 test to do univariate analysis of the dichotomy data chosen, then used Binary Logistic regression equation to do multi- factor analysis by SPSS 16.0 statistical software. Results: All patients were cured or improved after surgery, with no deaths. 17 cases got postoperative pulmonary infection, 7 cases had wound infection, 1 suffe red from bile-pleura fistula. complication rate was 10.87% (25/203). They were followed up for 1-10 years after surgery, follow-up rate was 80.3% (163 / 203), 12 cases with recurrence, the recurrence rate is 5.9% (12/203). Univariate statistica