有慢性阻塞性肺疾病食管癌的外科治疗

Surgical Treatment for Esophageal Cancer with Chronic Obstruction Puimonary Disease

有慢性阻塞性疾病（COPD）的食管癌，肺功能对手术的选择可作客现判断，时间肺活量是重要参数，但不能预测术后肺功能不全，必须结合具体情况作客观分析，COPD者有过多次自发性气胸，肺气肿明显，肺大泡弥散分布，肺间质纤维化明显，放射治疗后都易发生急性呼吸衰竭，术前控制呼吸道感染及支气管痉挛是减少术后并发症的关键，早期辨认并及时处理各类并发症有助于预防及抢救急性呼吸衰竭，呼气末正压辅助呼吸加血管扩张剂硝普钠，在预防及治疗本组急性呼吸衰竭时效果良好。

Pulmonary function test is a substantive judge for indication of operation inesophageal cancer patient, especially there is chronic obstruction pulmonary disease(COPD), FEV1 is the most important teat in pulmonary function, but can not predetermine postoperative pulmonary function condition. Spontaneous pneumothorax, pneumonectasis, bullous emphysema, fibra pulmonary disease, radiopulmonary disease withCOPD preddispose the patients easily to catch respirative failure (ARDS). Respiratorytract infections and bronchi - spasm must be controlled, and it may decrease complications, Early treatment for very complications is a favorable therapy for ARDS.Mechanical ventilation with PEEP was used for all in this groups, after tracheostomy, and shouldbe early performed. We treated ARDS with vascular dilatory drugs, recepted a good result.