摘要
目的 探讨老年肺癌术后呼吸衰竭的原因、预防和治疗。 方法 对我院 1995年 1月至 2 0 0 1年 1月 60岁以上的肺癌术后发生呼吸衰竭者 2 8例 ,并以同期手术未发生呼衰的 2 11例老年肺癌患者作对照 ,用 χ2 检验分析可能导致呼吸衰竭的高危因素。 结果 术后呼吸衰竭的发生率为 11 7% ( 2 8/2 39) ,病死率 2 1 4% ( 6/2 8)。呼衰组肺活量占预计值的百分比 (VC % )、最大通气量占预计值的百分比 (MVV % )、一秒钟呼气容积 (FEV1)、一秒钟呼气量占用力肺活量的百分比 (FEV1/FVC % )都明显低于无呼衰组 (P <0 0 1)。全肺切除组术后呼衰发生可能性明显高于肺叶和段 /楔形切除组 (P <0 0 1)。 结论 术前心肺功能异常、呼吸道感染、手术创伤和伤口疼痛刺激是引起术后呼吸衰竭的主要原因。及早诊断、及时行气管切开术并给予机械通气是抢救成功的最有效手段 ;加强围手术期呼吸道管理、避免手术后并发症是预防术后呼吸衰竭的关键。
Objective To explore the cause,prevention and treatment of post operative respiratory failure in elderly patients with lung cancer. Methods mechanical ventilation was given to 28 patients (≥60 years)with lung cancer for post operative respiratory failure in our hospital from January 1995 to January 2001,and 211 controls were analyzed by χ 2 test. Results The incidence of post operative respiratory failure was 11 7%(28/239).The mortality was 21 4%,VC%,MVV%,FEV 1,FEV 1/FVC% in respiratory failure group were all significantly lower than those in control group( P <0 01).The odds of respiratory failure was much lower in sleeve resection and lobectomy group than that in pneumonectomy group. Conclusions Respiratory tract infection,operative wound,incision pain,pre operative cardio pulmonary dysfaction,etc,are the major causes of post operative respiratory failure.Correct diagnosis,tracheotomy and mechanical ventilation as early as possible are the most efficient ways to save lives.Strengthening management on respiratory tract in peri operative period and avoiding post operative complications are the keys to preventing post operative respiratory failure.
出处
《实用老年医学》
CAS
2002年第2期88-90,共3页
Practical Geriatrics
关键词
肺肿瘤
外科手术
呼吸衰竭
机械通气
老年人
Lung neoplasms
*'Surgery
*'Respiratory failure
*'Mechanical ventilation
