肺癌术后发生急性呼吸窘迫综合征的发病特点及治疗  

Pathogenicity and treatment of acute respiratory distress syndrome following lung cancer surgery

作　　者：陈晓峰[1] 王律[1] 丁嘉安[1] 王海峰[1] 赵德平[1] 

机构地区：[1]上海市肺科医院胸外科,上海200433

出　　处：《中国癌症杂志》2001年第3期254-256,共3页China Oncology

摘　　要：目的 :探讨肺癌术后发生急性呼吸窘迫综合征 (ARDS)的原因及防治措施。方法 :回顾分析我院胸外科 1993年至 1998年 17例肺癌病人术后发生ARDS的发病特点 ,可能的原因及防治方法。结果 :患者有长期慢性肺部疾患、高龄、高血压病者 ,术后容易发生ARDS。休克、肺挫伤和肺部感染是发生ARDS的三大诱因。治疗应积极清除呼吸道分泌物 ,保持气道通畅 ,控制感染 ,利尿减轻肺水肿 ,尤其是尽早行气管插管或气管切开机械辅助通气为抢救成功的关键。结论 :肺癌术后发生ARDS的原因复杂 ,其中休克、肺挫伤和肺部感染等多因素的作用是肺癌病人术后发生ARDS的主要原因 。Purpose:To investigate methods of prevention and treatment,pathogenicity for Acute Respiratory Distress Syndrome (ARDS) following resection of pulmonary carcinoma. Methods:17 cases were analysed for characteristic of incidence, pathogenicity and treatment for ARDS following lung cancer surgery. Results:The subjects, who had chronic obstructie pulmonary disease, hypertension, senility or smoking for a long time were prone to ARDS. Injury to lung during operation, shock and pulmonary infection were probably causes ARDS. The keypoint treatments in rescuing patients successfully included clearing away respiratory tract secretion, preserving free ventilation of respiratory tract, controlling pulmonary infection, alleviating pulmonary edema by diuresis,early tracheotomy or mechanical ventilation by tracheointubation. Conclusions:It is suggested that factors were related to ARDS following resection of pulmonary carcinoma. Those such as shock, injury to lung in operation, pulmonary infection, are important factors leading to post operative ARDS of lung cancer patients. Early treatment can reduce mortality of ARDS. [

关 键 词：ARDS 病因 机械通气 肺癌 手术后 呼吸窘迫综合征 

分 类 号：R734.2[医药卫生—肿瘤] R563.8[医药卫生—临床医学]