同期主动脉置换并食管癌切除术的术后早期并发症护理  

Nursing care for early complications of simultaneous aortic surgery and esophagectomy for esophageal carcinoma

作　　者：曹涌[1] 景华[1] 申翼[1] 董国华[1] 

机构地区：[1]南京军区南京总医院心胸外科,南京210002

出　　处：《医学研究生学报》2010年第3期289-292,共4页Journal of Medical Postgraduates

基　　金：军队医药卫生"十一五"科研基金(06Z017)

摘　　要：同期主动脉置换并食管癌切除术的术后早期并发症监测与护理罕有报道。为探讨食管癌侵犯胸主动脉术后并发症的预防,文中分析了26例T4期食管癌侵犯胸主动脉患者术后护理经验。采用回顾性分析研究的方法,总结26例T4期食管癌侵犯胸主动脉患者术后并发症及其护理。26例患者中,12例出现术后并发症,占46.2%,包括心律失常5例,占19.2%,肺不张6例,占23.1%,其中2例老年患者发生呼吸衰竭再次气管插管,占7.7%,乳糜胸1例,占3.8%。所有患者均未出现主动脉瘘、吻合口瘘、截瘫等严重并发症。对上述并发症能及时发现、及时治疗,病情得到控制,26例患者均于术后2周内顺利恢复。对非心肺转流术(cardiopulmonary bypass,CPB)下食管癌侵犯胸主动脉患者术后早期并发症的护理进行分析,有利于术后临床观察,并及时预防,减少术后并发症和手术死亡率,提高手术疗效。Rarely reported is the monitoring and nursing care of the early complications following simultaneous aortic surgery and esophagectomy for esophageal carcinoma.This article presents the postoperative nursing experiences with 26 cases of Stage T4 esophageal carcinoma-invaded thoracic aorta,and discusses the prevention of postoperative complications in such patients.Postoperative complications developed in 12（46.2%） of the patients,of whom arrhythmia was found in 5（19.2%）,pulmonary atelectasis in 6（23.1%,including respiratory failure in 2 geriatric cases that required re-intubation）,and chylothorax in 1（3.8%）.All the complications were timely observed and managed,and no severe complications such as aortic fistula,anastomotic leakage or paraplegia were noted.All the 26 patients were recovered within 2 weeks after the operation.The nursing care experience was analyzed.Our experience may help the observation,timely prevention and effective reduction of postoperative complications and surgical mortality,as well as raise the success rate of operation in patients undergoing off-pump surgery for esophageal carcinoma-invaded thoracic aorta.

关 键 词：食管癌 胸主动脉 非心肺转流术 护理 

分 类 号：R655.4[医药卫生—外科学]