结核性毁损肺全肺切除术后并发心律失常的危险因素分析.docVIP

结核性毁损肺全肺切除术后并发心律失常的危险因素 分析 【 】目的评估结核性毁损肺全肺切除术后发生心律失常的危 险因素。 方法回顾分析2006年1月?2014年8月间90例因结核性毁损肺接 受全肺切除术患者的临床资料，用单因素分析及Logistic回归分析统计 术后发生心律失常的可能危险因素。 结果结核性毁损肺全肺切除术后心律失常的总发生率为27. 78%。单 因素分析显示，心律失常的发生与年龄、术前心电图异常、合并心血管基 础疾病、手术时间、术中出血量、MVV、FEV1、术后电解质紊乱相关（P1）。 结论 术前治疗心血管及肺部基础疾病，缩短手术时间，减少术中出 血量，术后纠正电解质紊乱，可减少术后心律失常的发生。 【关键词】结核性毁损肺；全肺切除；心律失常；危险因素 中图分类号：R541.7文献标识码：A DOI : 10. 3969/j. issn. 2015. 05. 009 Analysis of risk factors of complicated arrhythmia after total pneumonectomy for patients with tuberculous destroyed lung [HJ2][HJ] LIU Wei, WEI Ming, LIAO Yong, HUANG X辻ong (Department of Thoracic Surgery, Longtan Hospital, Liuzhou 545005, Guangxi, China) [HJ3][HJ] [Abstract ] Objective To investigate the risk factors of complicated arrhythmia after total pneumonectomy for patients with tuberculous destroyed lung? Methods A retrospective analysis was carried on to the clinical data of 90 patients who accepted total pneumonectomy from January, 2006 to August, 2014. Meanwhile, univariate analysis and multivariate logistic regression analysis were used to count potential risk factors of arrhythmia after operation. Results Total incidence of arrhythmia in total pneumonectomy for patients with tu berculous des troyed lung was 27. 78%. Uni variate analysis showed that age, electrocardiogram abnormality before operation, cardiovascular disease, operation time, bleeding in operation, MVV, FEV1 and electrolyte disorder after operation were correlated with postoperative arrhythmia (Pl)? Conclusion To treat cardiovascular and pulmonary underlying disease, shorten operation time, reduce intraoperative bleeding and correct electrolyte disorder after operation can effectively reduce the occurrence of postoperative arrhythmia? [Key words 】 tuberculous destroyed lung, total pn eum on ectomy, cardiac arrhythmia, risk factor 近年来，广西年肺结核报告发病率位居全国前列，肺结核并发的毁损 肺也逐年增多，成为我院胸外科最有特色、也是最难治的疾病之一［1］。 毁损肺患者肺组织反复感染、广泛纤维化、壁胸膜增厚等特点决定了内科 治疗效果差，外科行全肺切除则成为必要且有效的治疗手段［2］。但该手 术创面大、渗血多、技术难度大、风险高、术后并发症多仍是困扰胸