低肺功能肺癌手术治疗探讨  

ANALYSIS OF SURGICAL TREATMENT FOR LUNG CANCER PATIENTS WITH POOR PULMONARY FUNCTION

作　　者：齐占春 

机构地区：[1]唐山市第三医院外二科,河北唐山063100

出　　处：《河北医科大学学报》2008年第2期197-199,共3页Journal of Hebei Medical University

摘　　要：目的探讨低肺功能肺癌患者外科手术治疗后并发症、术后呼吸机的应用及术前肺功能检查的价值。方法64例低肺功能肺癌患者依据肺最大通气量(maximum ventilatory volume,MVV)和第1 s用力呼气量(forced expiratory volume in 1 second,FEV1)分为两组,第1组为重度异常,即MVV≤50%,FEV1≤45%的23例;第2组为50%<MVV<80%,45%<FEV1<70%的41例。第1组患者有18例术后使用呼吸机辅助呼吸。对比研究两组术后呼吸衰竭、心律失常、死亡的发生情况。结果第1组死亡3例,呼吸衰竭5例,心律失常9例;第2组无死亡,呼吸衰竭1例,心律失常5例。结论肺功能重度异常患者术后心肺并发症的发生率较高,但是低肺功能肺癌患者的手术治疗随着手术技术及器械的改进,术后呼吸机机械通气的广泛应用,可以相对扩大手术适应证,通过加强围手术期的管理,特别是术后的密切监护以及各种严重心肺并发症的及时处理,达到满意的手术效果。Objective To investigate the postoperative complication, application of postoperative respirator and the value of preoperative spirometry in lung cancer patients with poor pulmonary function. Methods According to preoperative maximum ventilatory volume（MVV） and forced expiratory volume in one second（FEV1 ）,64 lung cancer patients with poor pulmonary function were divided into 2 groups. Group 1 had 23 patients whose MVV≤50% and FEV1 %≤ 45%.Group 2 had 41 patients whose 50%〈MVV〈80% and 45% FEV1〈70%. Eighteen patients of group 1 were put on respirators. Compare the occurrence of postoperative respiratory insuff death ciency,arrhythmia and death between group 1 and group 2. Results There were 3 cases of 5 cases of respiratory insufficiency, 9 cases of arrhythmia in group 1, and no death, 1 case of respiratory insufficiency, 5 cases of arrhythmia in group 2. Conclusion The postoperative complication rate of group 1 is high. However, the improvement of operation instrument,advanced operation skill and the extensive application of postoperative respirator make it possible to operate on more patients with poor pulmonary function. Besides, if pay special attention to nursing and monitoring, and deal with the postoperative complication of heart and lung without delay, satisfying operation results can be achieved.

关 键 词：肺肿瘤 外科手术 通气机 负压 

分 类 号：R734.2[医药卫生—肿瘤]