合并慢性阻塞性肺病的老年直肠癌患者围手术期处理

Perioperative management of the elderly rectal carcinoma patients with chronic obstructive pulmonary disease

目的探讨合并慢性阻塞性肺病(COPD)的老年直肠癌患者的围手术期处理。方法对40例中度以上COPD直肠癌患者进行静态肺功能评估,并进行正确的围手术期处理,研究其对患者术后的影响。结果术后心律失常4例,COPD症状加重8例,肺部感染6例,二重感染4例,呼吸功能衰竭2例,内科治疗后均缓解;伤口感染5例,无围手术期死亡。结论虽然合并COPD患者增加了手术风险,但正确内科治疗及处理,可以降低手术并发症发生率。

Objective To study the perioperative management of the elderly rectal carcinoma patients with chronic obstructive pulmonary disease （COPD）. Methods Forty rectal carcinoma patients with COPD were evaluated with preoperative pulmonary function and all the patients were subjected to careful perioperative treatment. Prognoses of the patients were studied. Results Postoperative complications induded cardiac arrhythmia （4 cases）, aggravated symptoms of COPD （8 cases）, pneumonia （6 cases） ,dual infection （4 cases） ,respiratory failure （2 cases） ,wound infection （5 cases）. No perioperative death occurred. Conclusion Although COPD increases the risk in rectal carcinoma surgery of elderly patients,accurate perioperative management can decrease the incidence of complications.