摘要
目的探讨胸部肿瘤并慢性阻塞性肺疾病(COPD)病人的围手术期处理方法。方法回顾性分析56例胸部肿瘤并COPD病人的围手术期处理。术前预防和控制呼吸道感染,应用解痉化痰药物,进行呼吸功能锻炼和氧疗。术中应用双腔气管插管,减少对肺部的揉搓,彻底切除肺大疱,必要时同期行肺减容手术。术后行镇痛、保持呼吸道通畅、抗感染、心血管药物治疗、营养支持和氧疗,必要时进行机械辅助呼吸。结果术后31例恢复良好,痊愈出院。7例出现肺叶不张,6例出现不同程度的心律失常,经治疗痊愈。12例术后出现肺部感染,其中10例并发呼吸功能衰竭,8例给予呼吸支持后缓解,2例因严重感染不能控制,抢救无效死亡。结论严密的围手术期处理可以减少胸部肿瘤并COPD病人的术后并发症,提高手术成功率。
Objective To discuss the perioperative management of thoracic tumor patients with COPD. Methods Perioperative management of 56 thoracic tumor patients with COPD was analyzed retrospectively. Preoperative management included prevention of infection, use of apophlegmatistant, functional training of respiratory function and oxygen therapy. Double-cavity tracheal cannulas were used during operations to reduce the injury of lung, complete removal of bullas and lung-volume reduction to be done when needed. Postoperative analgesia, keeping smooth of respiratory tract, use of antibiotics and cardiovascular drugs, nutrition support and oxygen supply. Mechanically-assisted respiration was applied when necessary. Results Postoperative recovery was uneventful in 31 patients; atelectasis was encounted in seven patients; six with arrhythmia, all recovered after treatment： 12 patients had lung infection, of whom, 10 had respiratory function failure, and two died of severe infection. Conclusion Accurate perioperative management can reduce the postoperative complications for thoracic tumor patients with COPD and raise the success rate of surgery.
出处
《齐鲁医学杂志》
2006年第5期433-434,共2页
Medical Journal of Qilu
关键词
肺疾病
慢性阻塞性
胸部肿瘤
围手术期医护
pulmonary disease, chronic obstructive
thoracic neoplasms
perioperative care
