食管癌、贲门癌术后近期危重并发症死亡24例分析

Analysis of 24 cases with esophageal cardia cancer postoperative complications death recent

目的：探讨食管癌、贲门癌切除术后近期危重并发症,并对发生原因及死亡原因进行分析。方法：对2000年1月~2009年12月收治的食管癌、贲门癌术后近期危重并发症24例的临床资料进行回顾性分析。结果：肺部并发症9例,其中5例为原有肺部疾病（慢支、肺气肿）感染不能控制而发生呼吸衰竭,2例为术后回病房即出现呼吸衰竭,2例术后10~11d突然出现呼吸停止;心血管并发症6例,其中心律失常4例,术后第7天下床大便后休克2例;吻合口瘘6例,其中4例多器官功能衰竭,2例为吻合口瘘后放置支架而上消化道大出血;3例乳糜胸。结论：选择适当的适应证、充分的术前准备、恰当的手术方式和精确细致的操作、严密的术后观察、出现并发症后的积极有效治疗,都是降低术后并发症的关键。

Objective：To explore esophageal cardia cancer after resection,and the recent critical complications occurred reasons and cause of death for analysis.Methods：On January 2000-December 2009,the clinical date of drug-induced esophageal cardia cancer postoperative complications recent critical 24 cases were retrospectively analyzed.Results：Pulmonary complications in 9 cases,including 5 cases of original lung diseases（bronchitis and emphysema） infection cannot control and respiratory failure,2 cases for postoperative back ward namely appear respiratory failure,2 cases of postoperative 10-11 days appear suddenly stopped breathing,Cardiovascular complications,including 6 cases of arrhythmia 4 cases,postoperative 7 world bed after defecate shock 2 cases.Anastomotic leakage in 6 cases,4 cases of multiple organ failure,2 cases for anastomotic leakage after stent and massive hemorrhage of upper gastrointestinal tract resulted;3 cases of chylothorax.Conclusion：Proper selection of indication,sufficient preoperative preparation,appropriate surgical management and accurate meticulous operation,strict postoperative complications after observing,positive effective treatment,they are the key to reduce postoperative complications.