机械通气在高龄低肺功能食管癌患者术后的临床应用  

The clinical application of mechanical ventilation with esophageal carcinoma in the eldly and lower pulmonary function patients

作　　者：俞建琦[1] 刘颖[1] 张宝石[1] 于长海[1] 

机构地区：[1]解放军总医院第一附属医院胸心外科,北京100048

出　　处：《临床军医杂志》2011年第1期73-75,共3页Clinical Journal of Medical Officers

摘　　要：目的探讨机械通气在高龄肺功能低下食管癌术后的应用价值。方法选取56例术前肺功能(MVV≤50%和FEV1/FVC>45%)低下的食管癌患者,年龄(72.3±4.1)岁。其中术后行呼吸机辅助呼吸的37例为A组;术后常规治疗,未行呼吸机辅助呼吸的19例为B组。观察两组患者血氧饱和度、心律失常、动脉血气以及住院时间等情况。结果两组患者均无死亡病例。A组中脉搏血氧饱和度(97.6±1.4)%,心律失常发生率29.7%(11/37),呼吸机辅助呼吸时间(33.2±5.4)h,术后住院时间(7.6±2.3)d;B组中脉搏血氧饱和度(92.4±1.2)%,心律失常发生率47.4%(9/19),术后住院时间(10.1±3.1)d,其中2例因血氧饱和度降至80%,立刻行呼吸机辅助呼吸;两组术后血气的变化差异有统计学意义。结论对于肺功能低下的食管癌手术患者,应用机械通气辅助呼吸可扩大手术适应证,减少术后并发症。Objective To explore the applied value of mechanical ventilation with esophageal carcinoma in the eldly and lower pulmonary function patients.Methods 56 patients（average age：72.3±4.1）with esophageal carcinoma and lower pulmonary function（MVV≤50%,FEV1/FVC〉45%） were divided into 2 groups： Group A,37 patients were treated with assisted respiration after operation.Group B,19 patients weren＇t treated with assisted respiration after operation.We observe the SPO2,arrhythmia,arterial blood gas and postoperative length of stay in 2 groups,and record the time of assisted respiration in group A.Results All patients weren＇t dead.The patients in A group,SPO2 was（97.6±1.4）%,the incidence rate of arrhythmia was 29.7%（11/37）,the time of assisted respiration was（33.2±5.4）h,postoperative length of stay was（7.6±2.3）d.In B group,SPO2 was（92.4±1.2） %,the incidence rate of arrhythmia was 47.4 %（9/19）,postoperative length of stay was（10.1±3.1）d.SPO2 decreased to 80% and treated with assisted respiration in 2 cases.There was a significant difference in SPO2,the incidence rate of arrhythmia,postoperative length of stay and arterial blood gas.Conclusion It is a better way to enlarged the indication of surgical treatment and reduce the postoperative complications by using mechanical ventilation in patients with esophageal carcinoma and lower pulmonary function.

关 键 词：食管肿瘤 食管癌 肺功能低下 机械通气 

分 类 号：R735.1[医药卫生—肿瘤]