结核性毁损肺外科胸膜全肺切除手术后ICU治疗28例分析  

The treatment for the destroyed lung pleuropneumonectomy postoperative patients in ICU

作　　者：康乃民[1] 张秀娟 刘立群 

机构地区：[1]北京市结核病胸部肿瘤研究所ICU,北京101149 [2]北京市通州区新华医院内科,北京101101

出　　处：《中国防痨杂志》2006年第5期301-304,共4页Chinese Journal of Antituberculosis

摘　　要：目的提高对结核性毁损肺行全肺切除患者的围手术期ICU的治疗水平。方法对结核性毁损肺28例患者,于手术后住ICU监测治疗:动态监测生命体征、出血情况、肺功能、血气分析;治疗合并疾病;纤维支气管镜吸痰;应用呼吸机进行无创或有创机械通气,治疗急性呼吸衰竭。结果20例患者经过ICU加强诊疗,术后顺利恢复;8例患者出现急性呼吸衰竭,经过无创及有创呼吸机机械通气治疗后好转;2例合并胸腔感染、支气管残端瘘患者,其中1例死亡。结论结核性毁损肺胸膜全肺切除手术后病人的围手术期诊疗中,在动态监测病情、防治手术后应激反应、治疗手术后急性呼吸衰竭等方面ICU有明显优势。Objective To improve the treatment for the destroyed lung pleuropneumoneetomy postoperative patients in ICU. Methods 28 patients who suffered the destroyed lung by pulmonary tuberculosis have been selected to accept the surgical treatment, pleuropneumonectomy. All ment after operation including continuous monitoring patient＇ s life lung, the blood gas analysis; treating the complicated diseases; treating the acute respiratory failure by using ventilator. Results of them have accepted the intensive care treatsigns, the bleeding amount, the function of the getting rid of sputum by bronchofibroscope; Through the treatment in ICU, 20 patients smoothly recovered. 8 patients complicated with the acute respiratory failure accepted the ventilator, NPPV, or PSV ＋ PEEP ventilation, and recovered. 2 patients complicated with infection and fistulae of bronchial stump, among whom one patient died. Conclusions During the postoperative treatment for patients who accept pleuropneumonectomy, ICU department plays an important role in continuous monitoring and treatment, reducing stress, treating acute respiratory failure.

关 键 词：结核 肺/外科学 重症监护 

分 类 号：R655.3[医药卫生—外科学]