肺癌全肺切除术的围术期处理  

Perioperative management of pneumonectomy for lung cancer

作　　者：张昱[1] 姜芸[1] 刘亚华[1] 

机构地区：[1]新疆医科大学附属肿瘤医院ICU,乌鲁木齐830011

出　　处：《中国实用医药》2011年第31期34-35,共2页China Practical Medicine

摘　　要：目的总结肺癌全肺切除术的围术期处理经验。方法对2006年1月至2010年12月行全肺切除术的31例肺癌病例的临床资料进行回顾性分析,其中左全肺切除27例(87.1%),右全肺切除4例(12.9%)。结果 31例患者中,术后发生心律失常5例(16.1%)、肺不张伴感染2例(6.5%)、急性肺水肿1例(3.2%),均经积极治疗痊愈。1例(3.2%)74岁老年患者术后发生支气管胸膜瘘合并脓胸,最终死亡。结论严格掌握手术适应证,术前准备充分,术中操作规范熟练,术后机械通气呼吸支持,重视围术期液体管理,对常见并发症重点防范、早期治疗,能明显降低术后并发症和死亡率。Objective To review the perioperative management of pneumonectomy for primary lung cancer.Methods The clinical data for 31 cases of pneumonectomy for lung cancer were analyzed retrospectively from January 2006 to December 2010,included 27 patients（87.1%） left pneumonectomy,4 patients（12.9%） right pneumonectomy.Results Postoperative complications occurred in 9 cases（29.0%）,including arrhythmia of 5 cases（16.1%）,atelectasis and pulmonary infection of 2 cases（6.5%）,acute pulmonary edema of 1 case（3.2%）.They were healed by active heteropathy.1 case（3.2%） of seventy-four years old man suffered bronchopleural fistula combined empyema after the operation and died in the end.Conclusion On the basis of strict indication,plenary preparation before operation,practiced thoracic operation,mechanical supplementary respiration,managment of transfusion in the perioperative period,the postoperative complications and mortality can be decreased obviously.

关 键 词：肺癌 全肺切除术 围术期 

分 类 号：R734.2[医药卫生—肿瘤]