Ⅲ期肺癌术后早期主动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 postoperative pneumonitis and atelectasis in the patients with lung cancer of state III.

目的总结III期肺癌术后肺部并发症的防治经验和评价术后早期主动纤维支气管镜吸痰的临床防治效果。方法332例肺癌患者中173例高危患者术后3d内主动应用纤维支气管镜床边吸痰,强化呼吸道管理。将患者分为强化治疗组(173例)和非强化治疗组(159例),观察各组肺部并发症情况。结果非强化治疗组术后肺部感染、支气管胸膜瘘发生率、气管切开率和死亡率分别为9.7%、8.2%、9.4%和9.4%;强化治疗组分别为4.0%、2.9%、3.4%和2.9%。两组间差异均有显著性意义(P<0.05)。结论Ⅲ期肺癌手术后肺部并发症发生率较高。术后早期主动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。值得临床推广。

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 June 2001 ,some preventive fribrobronrnchoscopy treatments during the early phase after operation for post-operative pneumonitis and atelectasis were carried out in 173 pratients among 332 patients. All patienst were divided into two groups according that. Results Patients（9. 7%） in the group of inchoate 159 patients before June 2001 had been found post-operative pneumonitis and atelectasis. 15 patient was dead because of lung infection; 7 patient（4. 0%）in the group of 332 patients who underwent operation after March 2004 had been found post-oerative pneumonitis and atelertasis amd only 5 patients（2. 9%）died. Conclusion More post operative pneumonitis and atelectasis happened in patients with lung cancer of state Ⅲ. To take initiative fribrobronchoscopy treatment during the early phase afrer operation can decrease the post-operative pneumonitis and atelectasis and raise the safety on the operation.