肺癌术后呼吸衰竭26例分析

Post operative respiratory failure in lung cancer patients

目的 探讨肺癌术后呼吸衰竭的原因、预防及治疗。方法 对我院1990年1月至1997年10月肺癌术后发生呼吸衰竭的26例患者均进行了机械通气治疗,19例行气管切开术。结果 术后呼吸衰竭发生率4.7%(26/558),死亡率23.1%(6/26)。结论 呼吸道感染、手术创伤、伤口疼痛刺激、术前心肺功能异常等是引起术后呼吸衰竭的主要原因。尽早诊断、及时行气管切开术并给予机械通气是抢救成功的最有效手段,加强围手术期呼吸道管理、避免手术并发症是预防术后呼吸衰竭的关键。

Objective To explore the reasons, prevention and treatment measures of post operative respiratory failure in lung cancer patients. Methods Mechanical ventilation was given to 26 lung cancer patients with post operative respiratory failure in our hospital from January 1990 to October 1997, and 19 out of them received tracheotomy.Results The incidence of post operative respiratory failure was 4.7%(26/558). Twenty cases were cured and 6 died ( 23.1% ).Conclusion Respiratory tract infection, operative wound, incision pain, abnormal pre operative cardio pulmonary function, etc, are the major reasons which caused post operative respiratory failure. Correct diagnosis, tracheotomy as early as possible and mechanical ventilation are the most efficient ways to save lifes. Strengthening management on respiratory tract in peri operative period and avoiding post operative complications are the keys of preventing post operative respiratory failure.