中国普外基础与临床杂志

中国普外基础与临床杂志

普外科非计划再手术患者预后转归的相关分析

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目的 探讨普外科非计划再手术患者预后转归的相关因素。 方法 回顾性分析 2014 年 1 月至 2017 年 5 月期间上海交通大学医学院附属第九人民医院北部普外科发生的 85 例非计划再手术患者的临床资料,收集患者的术前基本资料、手术相关资料和术后有关资料,分析影响非计划再手术患者死亡的相关因素。 结果 85 例非计划再手术患者中治愈 72 例,死亡 13 例。单因素分析结果显示高龄、患有基础疾病、择期手术、麻醉 ASA 分级高、非计划再次手术术前血红蛋白<90 g/L、非计划再手术手术时间长、术后转入 ICU、再手术术后发生相关并发症及多次进行非计划再手术患者的术后死亡较高(P<0.05),进一步行 logistic 多因素回归分析显示高龄、非计划再手术术前血红蛋白<90 g/L 和再手术术后并发症是非计划再手术患者术后死亡的独立危险因素(P<0.05)。死亡患者的出院满意度明显低于治愈组(P<0.05)。 结论 高龄、非计划再手术术前血红蛋白<90 g/L 和再手术术后并发症是非计划再手术患者预后的独立影响因素。

Objective To explore prognostic factors of unplanned reoperation in Department of General Surgery. Methods The clinical data of 85 patients with unplanned reoperations who treated in the Department of General Surgery, the Northern District of the Shanghai Ninth People’s Hospital from January 2014 to May 2017 were retrospectively collected. The risk factors such as preoperative basic information, surgical related information, and postoperative information for death of unplanned reoperations were analyzed. Results There were 72 cured patients and 12 deaths in the 85 patients with unplanned reoperations. The univariate analysis results showed that the elderly patients, basic diseases, selective operation, high grade of ASA, preoperative hemoglobin <90 g/L, longer operative time, admission to ICU after unplanned reoperations, postoperative complications, and multiple unplanned reoperations were correlated with the high mortality of unplanned reoperations ( P<0.05). The multivariate analysis results showed that the elderly patients, preoperative hemoglobin <90 g/L, and postoperative complications were the independent prognostic factors (P<0.05). The satisfaction of patients at discharge in the death group was significantly lower than that in the survival group (P<0.05). Conclusion Ederly patients, preoperative hemoglobin<90 g/L, and postoperative complications are independent prognostic factors of unplanned reoperations in Department of General Surgery.

关键词: 非计划再手术; 预后; 危险因素

Key words: unplanned reoperation; prognosis; risk factor

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