肺癌术后呼吸功能衰竭的原因分析  

Causes of post-operative respiratory failure in patients with lung cancer

作　　者：马秉灵 刘晓恩[2] 张桂梅 贺丕瑞 刘凯 

机构地区：[1]汾阳医院胸心外科,山西032200 [2]大同市第五人民医院

出　　处：《中国肿瘤临床与康复》2002年第6期109-110,共2页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的　探讨肺癌术后发生呼吸功能衰竭的原因。方法　 192例肺癌病人均在双腔支气管插管静脉复合麻醉下分别行不同术式的外科治疗 ,并对术后发生呼吸衰竭的临床资料进行分析。结果　全组手术病人术后发生呼吸衰竭 12例 (6.3 % ) ,其中男 8例、女 4例 ,年龄 41～ 71岁 ,60岁以上者 8例。术后呼吸衰竭组的术前肺功能指标 (VC %、MVV %、FEV1%或FEV1)均明显低于无呼吸衰竭组 (P <0 .0 1)。全肺切除术后发生呼吸衰竭明显高于肺叶切除及其它术式 (P <0 .0 1)。结论　肺癌术后发生呼吸衰竭主要原因与术前肺功能及手术方式直接相关 ,术前VC %、MVV % <60 %、FEV1% <5 0 %或FEV1<1.5L易发生呼吸衰竭 ,手术切除范围大也易发生呼吸衰竭。此外 ,患者的年龄与术后呼吸衰竭有密切关系。Objective To analyze the factors of post operative respiratory failure in patients with lung cancer.Methods The clinical data of patients with post operative respiratory failure were analysed among 192 patients with lung cancer who were treated by different operative modes in dual cavity bronchus vessel introducing intravenous combined with anesthesia.Results Among the cases,12 had post operative respiratory failure(6.3%),of whom 8 were male and 4 were female with an average age of 41～71 and 8 above 60.The preoperative pulmonary function levels (VC%,MVV%,FEV 1% or FEV 1)of the post operative respiratory failure group were obviously lower than those of the group without post operative respiratory failure(P<0.01).The rate of post operative respiratory failure was obviously higher in the patients undergoing total pneumonectomy than in the patients undergoing pulmonary lobectomy or other operations(P<0.01).Conclusion The main cause of post operative respiratory failure in patients with lung cancer is directly related with preoperative pulmonary function and operative modes.The patients with VC%<60%,MVV%<60%,FEV 1%<50% or FEV 1<1.5L or/and of large range resection might have postoperative respiratory failure, and the age is also related with post operative respiratory failure.

关 键 词：肺癌 术后 呼吸功能衰竭 原因分析 

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