陈丽莉 王红鹰 蒿汉坤 上海医科大学附属华山医院普外科(上海 200040) 中国普外基础与临床杂志 1999 0 6 5


    关键词：老年患者；腹腔感染术后；肺损害；低氧血症；成人呼吸窘迫综合征 期刊 zgpwjcylczz 0 临床研究 fur -->


    

摘要 为探讨老年患者腹腔感染术后肺损害的发生及其防治措施，对我院外科1991年1月至1992年12月收治的77例60岁以上的腹部外科疾病患者，术后给吸氧处理后的血氧饱和度(SaO₂ )进行了连续监测，其中伴腹腔感染者(感染组)38例，无腹腔感染者(非感染组)39例。结果：感染组术后SaO₂ <95%者28例，其低氧血症发生率为73.7%，非感染组SaO₂ <95%者12例，其低氧血症发生率为30.8%，两组比较差异有显著性意义(P<0.001)。对术后SaO₂ <95%的40例患者给予吸氧处理后，其低氧血症得以改善31例，有效率达77.5%；而低氧血症未纠正者9例，均并发成人呼吸窘迫综合征(ARDS)，发生率为2.5%(9/40)，其中感染组并发ARDS者8例，发生率为21.1%，非感染组1例，发生率为2.6%，两组比较，差异有显著性意义(P<0.05)。该结果提示：老年患者腹腔感染术后易并发低氧血症，且易发展成ARDS。因此老年患者腹腔感染术后，常规进行血氧饱和度的临床监测和吸氧治疗，是防治肺损害的重要措施之一。

PREVENTION AND TREATMENT OF PNEUMONIC INJURYAFTER OPERATION IN AGED PATIENTS WITH ABDOMINAL INFECTION

Chen Lili, Wang Hongying, Hao Hankun. Department ofGeneral Surgery, Huashan Hospital, Shanghai Medical University, Shanghai 200040

Abstract To evaluate thedevelopment prevention and treatment of pneumonic injury after operation on aged patientswith abdominal infection. We analyzed 77 aged patients (>60 y) admitted from Jan. 1991to Dec. 1992: 38 cases of which with abdominal infection (infection group), 39 caseswithout abdominal infection (non-infection group). All patients were given oxygen therapyand continuous SaO₂ monitoring. Results: There were 28 patients with hypoxemia(SaO₂ <95%) in infection group, with an occurrence rate of 73.7%. Innon-infection group (12 patients), the rate of hyoxemia was 30.8%, which has significantdifference between two groups (P<0.001). All patients with hypoxemia were given oxygentherapy and 31 patients′ SaO₂ was elevated. The efficient rate was 77.5%.Other 9 patients developed ARDS, the rate was 2.5% (9/40). In the infection group 8patients developed ARDS with an occurrence rate of 21.1%. There was one patient with ARDSin the non-infection group, the rate was 2.6%. There was significant difference betweentwo group (P<0.05). Conclusions: The results suggest that hypoxemia is liable to occurin aged patients with abdominal infection after operation and these patients were liableto develop ARDS. Oxygen therapy and SaO₂ monitoring is the importantmanagements to these patients in prevention of pneumonic injury.

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