20例肺癌合并慢性阻塞性肺部疾病患者肺叶切除术的围手术期处理  

Peri-operative Management in Lung Cancer Patients Compli with Chronic Obstructive Pulmonary Disease

作　　者：吴新天[1] 张胜辉[1] 王轶灵[1] 

机构地区：[1]上海市第十人民医院胸心外科,上海200072

出　　处：《中国临床医学》2005年第5期801-802,共2页Chinese Journal of Clinical Medicine

摘　　要：目的：探讨肺癌合并慢性阻塞性肺部疾病(COPD)患者的围手术期处理。方法：对20名中度以上 COPD 肺癌患者进行静态肺 功能评估，并行适当的围手术期处理，研究其对患者手术预后的影响。结果：3例术后行纤维支气管镜吸痰，12例哮喘发作予支气管 扩张药并静脉注射。肾上腺皮质激素后缓解，8例术后早期即给予口鼻面罩支持，所有患者术后痊愈出院。结论：术前呼吸减退的 COPD 肺癌患者并非外科手术的绝对禁忌症，术前锻炼和围手术期无创正压通气(NPPV)支持有助于术后呼吸功能的锻炼和康复。Objective： To study the character of peri- operative management in lung cancer patients with chronic obstructive pulmonary disease （ COPD ）. Methods：Preproative pulmonary function of 20 lung cancer patients with COPD were evaluated then all the potients were given careful peri - operative management, prognosis of patients were studied. Results： After operation, 3 patients had mucus plug requiting bonchoscopic suction. Bronchospasm occurred in 12 patients and resoloved after inhalation of bronchodilator and intravenous administration of corticostreoid. All patients recovered smoothly and discharged from hospital. Conclusion：Severe lung cancer patients with COPD are not the absolute contraindication of operation. Preopration chest exercise might be condution to maintain and recovery of postoperation respiratory funtion. It should be necessary to initiate NPPV training perioperatively in patients with high risk of postoperative pulmonary complications.

关 键 词：肺癌合并COPD 术前肺功能评估 术前锻炼 无创正压通气 

分 类 号：R655[医药卫生—外科学]