食管癌、贲门癌围手术期死亡原因分析

Analysis of the reasons for perioperative death in patients with esophageal and cardiac carcinoma

目的:分析食管癌、贲门癌围手术期的死亡原因。方法:对56例食管癌、贲门癌围手术期死亡患者的临床资料进行回顾性分析。结果:56例死亡患者的死亡原因:肺部并发症29例(51.8%),吻合口瘘11例(19.6%),失血性休克6例(10.6%),多器官功能衰竭3例(5.4%),乳糜胸致全身衰竭3例(5.4%),胃后坏死、脓胸1例(1.8%),心脏性猝死1例(1.8%),心力衰竭1例(1.8%),膈疝引起绞窄性肠梗阻中毒性休克1例(1.8%)。结论:严格掌握手术适应证、改善患者术前肺功能状况、选择合理的手术范围及术式、正确处理术后并发症对降低食管癌、贲门癌的围手术期死亡率有重要意义。

Objective： To analysis the cause of the perioperative death in patients with esophageal and cardiac carcinoma. Methods： Clinical meterial of 56 patients with esophageal and cardiac carcinoma who died during the perioperative period were retrospectively analyzed. Results： The causes of 56 patients who died were as follows： 29 patients died from the complication of respiratory system,11 patients died from anastomotic leaking,6 patients died from hemorrhagic shock,3 patients died from multiple organ failure, 3 patients died from whole body failure caused by chylopleura, 1 patient died from empyema and gastric necrosis, 1 patient died from sudden cardiac death, 1 patient died from heart failure, 1 patient died from strangulating intestinal obstruction and toxic shock caused by diaphragmatic hernia. Conclusions： Mastering operative indications seriously, Improvement of pulmonary function before operation, selecting reasonable operative size and mode, curing postoperative complications correctly may play an important role in the decrease of operative mortality.