食管癌术后的呼吸功能

Study of the pulmonary function after the operation for esophageal and cardia cancinoma

目的探讨食管癌病人手术后呼吸功能变化的规律。方法 2002年1月至2006年1月,选取200例食管癌病人,行食管癌切除食管胃弓上吻合术100例,弓下吻合术100例。在手术前3 d 和手术后1、2、3、5、7、10、14 d 进行肺功能和血气分析测定,动态观察呼吸功能的变化规律。结果肺功能各项指标于术后第2 d 降至最低,以后呈逐渐升高趋势,至术后14 d 恢复到术前的60%;动脉氧分压恢复到术前的90%。肺功能各项指标、动脉氧分压弓上吻合术较弓下吻合术低。结论食管癌术后呼吸功能明显减退,造成低氧血症,应积极纠正。

Objective To study the change of the pulmonary function after the operation for esophageal and cardia cancinoma. Methods 200 patients with esophageal and cardia cancinoma underwent esophagectomy and cardiectomy. Site of esophagogas-troanastomasis was above aortic arch in 100 cases and under aortic arch in 100 cases. Patients were monitored from the 3rd preoperative day to the 14th postope retire day for pulmonary function and blood gas analysis. Results All indices of the pulmonary function were the lowest on the 2nd postoperative day. Then they began to ascend gradually and reach 60% of preoperation in the 14th postoperative day. PaO2 was the lowest on the 2nd postoperative day. Then they began to increase gradually and reach to 90% of baseline in the 14th postoperative day. The pulmonary function and blood gas analysis was reduced significantly for esophagastric anastomasis above aortic arch. Conclusion The pulmonary function after esophagectomy and cardiectomy for esophageal and cardia cancinoma decreases markedly, leading to hypoxemia which should be aggressively handled.