全肺切除术后围手术期并发症的临床分析

The clinical analysis of complication underwent pneumonectomy in the perioperative period

目的:探讨和评估全肺切除术后围手术期并发症的危险因素和防治办法。方法:回顾分析4 8例全肺切除术后围手术期并发症病例资料。结果:10 1例全肺切除术后围手术期发生并发症4 8例(47.5 % ) ,其中死亡4例;呼吸循环衰竭4例,2例死亡;心律失常2 7例;支气管胸膜瘘合并脓胸2例,1例死亡,肺不张伴感染7例;血胸4例;急性肺水肿4例,1例死亡。结论:病人的年龄、心肺疾病史、围手术期的输液管理、感染是发生并发症和死亡相关的主要危险因素;充分的术前准备、术后监护、机械辅助呼吸、呼吸功能锻炼能减少此类并发症和死亡率。

Objective:Discuss and evaluate dangerous factor and the method of prevention and cure for pneumonectomy in the perioperative period. Method:To retrospectively analysed 48 case for complication information underwent pneumonectomy in the perioperative period from March 1995 to March 2005. Result:Occur 48 complication cases ( 47.5%) in 101 cases underwent pneumonectomy in the perioperative period, In which 4 death examples; 4 cases with respiratory circulating failure, 2 death cases;The 27 cases of abnormal rhythm of the heart;2 bronchus-pleural fistula combined pyothorax examples, 1 death case; 7 cases of Lung non-open companion influence; 4 hemothorax cases; 4 acute lung oedema cases and 1 case death. Conclusion:Heart lung disease and the age of patient, management of transfusion in the perioperative period, infection which is occur complication and death is related major dangerous factor; Plenary preparation before operation and wardship after operation, mechanical supplementary respiration and respiration function exercise can reduce this kind of complication and death rate.