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作 者:杜振宗[1] 任华[1] 宋剑非[2] 张超纪[1] 于洪泉[1] 苗齐[1]
机构地区:[1]中国医学科学院中国协和医科大学北京协和医院胸心外科,北京100730 [2]桂林医学院附属医院胸心外科
出 处:《中华肿瘤杂志》2006年第2期148-150,共3页Chinese Journal of Oncology
摘 要:目的总结体外循环下切除原发性气管恶性肿瘤围手术期的处理经验。方法自1999年12月至2003年8月,6例原发性气管恶性肿瘤患者在体外循环下行肿瘤切除术。2例患者经右股动、静脉插管行急诊手术,4例患者开胸经右心房和升主动脉插管建立体外循环。3例患者行气管环形切除、气管断端行端端吻合;2例患者行气管下段和隆突切除、隆突重建;1例患者行肿瘤剔除术。术前和术后给予雾化吸入,协助咳痰,保持呼吸道通畅。结果术后呼吸困难均有明显好转,呼吸机辅助呼吸10h^7d,全组无手术死亡。结论对于气管严重梗阻的原发性气管恶性肿瘤患者,体外循环下行肿瘤切除是有效的治疗方法,术前和术后保持呼吸道通畅有利于术后恢复。Objective To retrospectively review the perioperative management for primary tracheal malignant tumors resected under cardiopulmonary bypass. Methods The data of 6 patients with primary tracheal malignant tumors who underwent surgery under cardiopulmonary bypass from December 1999 to August 2003 were reviewed. Cardiopulmonary bypasss was established through right femoral vessels in 2 patients for emergency operation, through right atrium and ascending aorta in 4 patients. Sleeve tracheal resections in 3 patients, carinal resections and carina reconstructions in 2, and local enucleation in 1 were performed. Respiratory airway was kept patent by coughing and expectorating sputum. Results All patients' dyspnea were relieved remarkablely. The postoperative mechanic ventilation assistance lasted from 10 hours to 7 days. There was no perioperative mortality. Conclusion Resection of primary tracheal malignant tumors with severe tracheal obstruction under cardiopulmonary bypass is practicable. Keeping respiratory airway patent perioperatively is very important and helpful to postoperative recovery.
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