安置心脏起搏器的剖胸手术治疗

Surgical treatment with thoracotomyafter installing pacemaker

胸部肿瘤患者同时伴某些心胜严重疾患，以往常因心脏问题而不能耐受剖胸手术而失去手术机会。本文报告贲门癌、食管疾各一例，患者同时伴病态窦房结综合征。先期安置心脏起搏器，调节检测保证良好起博功能，做好围术期管理，再施剖胸手术获得成功。作者认为安置心脏起博器，再施开胸手术切除胸部肿瘤这一方法对某些有严重心脏疾患而在常规条件下不能耐受胸外科治疗的患者是一种新的尝试。其方法扩大了胸外科手术适应症，提高了胸部肿瘤的治愈率。

Patients with thoracic tumor accompanying seriously cardiac diseases for instance sick syndrome(SSS), atrioventricular block and so on used to lose the best therapeutic method-combined treatment whose main part is operation, because their cardiac function can't tolerate thoracotomy. This paper reports two cases which are cardia and esophagus carcinoma respectively, accompanying sick sinus syndrome.Installing a pacemaker and full perioperative preparation including preoperative training of cardiac and pulmonary function, adjustment of pacemaker, postoperative nursing, decreasing accessory injury of intraoperation, avoiding electrical interferrence'and preventing complicatian are the key of successful operation. The writer consider that installing a pacemaker and then performing thoracotomy to resect tumor is a effective attempt ofr the patients with sick sinus syndrome. This method is sate and feasible. It extend the operative indication , increase the cure rate and survival period.