老年食管癌、贲门癌术后肺部并发症原因分析及防治

POST-OPERATIVE PULMONARY COMPLICATION IN GERONTAL PATIENTS WITH CANCER OF ESOPHAGUS AND GASTRIC CARDIA

[目的]探讨老年食管癌、贲门癌患者术后肺部并发症的原因及防治。[方法]179例手术切除老年食管癌、贲门癌患者中,术后39例发生肺部并发症,为并发症组:其余140例为对照组。用χ2检验比较两组患者的多项指标的差异。[结果]术前合并肺部疾病、术前肺功能明显异常、吸烟、主动脉弓上吻合、手术多切口、手术时间≥3h、术前放疗者在并发症组中所占比例明显高于对照组(P﹤0.05或P﹤0.01)。[结论]术前合并肺部疾病、术前肺功能明显异常、术前放疗、吸烟、吻合平面高、手术多切口、手术时间长等是肺部并发症的高危因素。围手术期的综合处理和手术技巧是避免食管癌、贲门癌术后发生肺部并发症的重要措施。

[Objective] To analyze the reasons for post-operative pulmonary complication in gerontal patients with cancer of esophagus and gastric cardia. [Methods] Of the 179 gerontal patients with cancer of esophagus and gastric cardia, 39 patients who had pulmonary complications were included into the complication group and the other 140 served as controls. X^2 test was used to compare the indices of the two groups. [ Results] The gerontal patients who were 65 years old or older, or suffered from pulmonary diseases before the operation, or whose preoperative pulmonary, function was worsening, or given preoperation radiotherapy, or smoking, or with the esophagogastrie anastomosis site above aortic arch, or with muhitude operative incision, or whose operation lasted for more than 3 hours were with a obviously higher proportion in the pulmonary complication group than in the control group （P 〈 0.05 or P 〈 0.01） . [Conclusion] Preoperative puhnonary diseases, preoperative puhnonary fimction abnormality, high location of anastomosis and long operation time are all the risk factors of post-operative pulmonary complication in patients with esophageal and cardiac carcinoma, his significant to strengthen intensive preoperative treatment and improve operation skills.