高龄高危肺癌患者外科治疗(附41例报告)

Experience of surgical trentment to excision of lung carcinorma in the aged and with cardiac or respiratory insufficiency

目的:为了探讨高龄高危肺癌患者的外科治疗经验.方法和结果:作者对1989年6月～1997年5月手术切除的41例高龄高危肺癌患者进行分析,由于强化围术期管理和正确处理并发症,取得了满意的治疗效果,全组无住院死亡.作者强调积极术前准备,创造有利手术条件,选择合理手术方法,加强术后心功能保护及呼吸道管理,特别是环甲膜穿刺注药刺激咳嗽排痰,气管镜检查吸痰、抗菌素药液支气管灌洗及酌情合理使用呼吸机等.结论:上述措施均为扩大手术适应范围安全度过手术难关创造了十分有利的条件.

objective:To Explore the experience of surgical treatment of lung carcinorma in aged and with cardia or respirato-ry insufficiency. Methods:From June 1989 to May 1997,surgical treatment was performed on 41 cases of lung cancer in aged and with cardiac or respiratory insufficiency. Results:The patients was satistactory because a series of the effective measure of periop-erative management were taken. There was no death in hospital. The author suggested that perioperative managment of lung can-cer in patients over 70 years of age and with cardiac or respiratory sufficiency should emphasized. They included to make well pre-operative ready,select correctly operative method and improve cardiac function through drugs. The author stress especially respira-tory tract management: to irritate cough sputum out; examination and suction with bronchef iberoscope; tracheo-bronchial lavage through bronchofiberoscope with antibiotics solution; and tracheotomy using ventilator appropriately perioperative intensive man-agement. Conclusion: The things mentioned above are very improtant for extending operation and tiding over critical period.