食管癌术后近期死亡临床分析

Clinical analysis of operative mortality following resection of esophageal cancer

目的探讨预防和减少食管癌手术死亡的措施。方法分析1989-2007年食管癌切除术后30d内死亡病例,并与1981-1988年手术死亡情况比较。结果手术死亡率为0.9%(13/1521),较以前明显下降(P<0.001);主要死亡原因为心肺并发症,占76.9%,术前多伴有心血管、肺部疾患等并发病;吻合口瘘、大出血的死亡率降低,无单纯脓胸和乳糜胸致死者。结论预防和减少食管癌切除术后并发症的发生是降低手术死亡率的最主要途径:术前充分处理并发病,选择恰当手术时机,术中、术后加强监护治疗,是降低手术死亡的有效措施。

Objective To study the prevention measures of operative mortality following the resection Of esophageal carcinoma. Methods Analyses the cases of 30 days mortality were analyses in the period those form 1989 to 2007 ,and compared with that in the period form 1981 to 1988. Results The operative mortality rate is 0.9% （ 13/1521 ） , which is significantly lower than that in previous group（ P 〈 0. 001 ）. The main causes of death is the complication of cardiovascular and pulmonary （ 76.9% ） , which mostly accompanied concerned with preoperative complicated diseases. The mortality of anastomotie leak and hemorrhage has been reduced. No mortality is relevant relative to the empyema without leak and chylothorax. Conclusions The best way to reduce the mortality is to prevent the complication following the resection of esophageal cancer. It is important to making the preoperative preparation and correction for the preoperative, also selecting the proper operation time, and performing the postoperative monitoring.