Ⅲ期肺癌术后早期纤维支气管镜吸痰预防肺部并发症的临床效果

Preventive effect of initiative fribrobronchoscopy treatment during the early phase after operation for post-operative pneumonitis and atelectasis in the patients with lung cancer of state Ⅲ

目的:探讨Ⅲ期肺癌术后早期纤维支气管镜吸痰预防肺部并发症的临床效果。方法:对华中科技大学同济医学院附属同济医院1998年1月～2005年6月行手术治疗的Ⅲ期肺癌的425例临床资料进行回顾性分析,按时间段分为2组:(1)1998年1月～2001年6月为非强化治疗组(93例),年龄(54.6±7.7)岁;(2)2001年6月～2005年6月为强化治疗组(332例),年龄(60.0±6.9)岁。332例患者中173例高危患者术后应用纤维支气管镜床边吸痰,强化呼吸道管理。结果:非强化治疗组术后肺部感染发生率、支气管胸膜瘘发生率、气管切开率和死亡率分别为9.7%、4.3%、6.5%和3.3%;强化治疗组分别为4.2%、1.5%、3.3%和1.2%,2组间比较差异有统计学意义(P<0.05)。结论:术后早期采取纤维支气管镜吸痰是降低肺部并发症和提高手术安全性的有效措施。

Objective： To review the preventive effect of initiative fribrobronchoscopy treatment during the early phase after operation for post-operative pneumonitis and atelectasis in the patients with lung cancer of state Ⅲ Methods： From Jan. 1998 to June 2005, Among 425 patients underwent pulmonary resection （at least lobectomy） and systematic mediastinal lymph node dissection for lung cancer of state Ⅲ in Tongji hospital, From June 2001, some preventive fribrobronchoscopy treatments during the early phase after operation for post-operative pneumonitis and atelectasis were carried out in 173 patients among 332 patients. All patients were divided into two groups according that. Results： 9 patients （9.7%） in the group of inchoate 93 patients before June 2001 had been found post-operative pneumonitis and atelectasis. 3 patient was dead because of lung infection; 14 patient （4.2%） in the group of 332 patients who underwent operation after March 2004 had been found post-operative pneumonitis and atelectasis and only 4 patients （1.2%） died. Conclusion： More post-operative pneumonitis and atelectasis happened in patients with lung cancer of state З To take initiative fribrobronchoscopy treatment during the early phase after operation can decrease the post-operative pneumonitis and atelectasis and raise the safety of the operation.