老年食管贲门癌术后呼吸衰竭的临床分析

The Clinical Analysis of Postoperative Respiratory Failure of the Elderly Patients with Esophageal and Cardiac Carcinoma

目的分析老年食管贲门癌患者术后发生呼吸衰竭的高危因素。方法对68例老年食管贲门癌患者术后临床资料进行回顾性分析。结果 68例老年食管贲门癌中,术后发生呼吸衰竭14例（20.6%）,死亡2例（占呼吸衰竭病例数的14.3%,占病例总数的2.9%）。术后呼吸衰竭发生时间从手术结束、麻醉苏醒后不能脱离呼吸机至术后7 d。呼吸衰竭患者应用呼吸机治疗时间为1~12 d。结论术前心肺功能差、肺部原发疾病、肥胖症、手术创伤、术后切口疼痛、肺部感染、胸胃扩张、吻合口瘘、胃贲门残端瘘等与老年食管贲门癌患者术后呼吸衰竭有关。

Objective To analyze the risk factors related to postoperative respiratory failure of the elderly patients with esophageal and cardiac carcinoma.Methods The clinical data of 68 elderly patients with postoperative esophageal and cardiac carcinoma were analyzed retrospectively.Results Among the 68 elderly patients with esophageal and cardiac carcinoma,14 cases（20.6%） evolved acute respiratory failure and 2 cases（2.9%） were dead.When respiratory failure took place,as ranged from when the tracheal tube couldn′t be taken away successfully to 7 days after operation and the lasting period of ventilator used from 1 day to 12 days.Conclusion The main factors related to postoperative respiratory failure of the elderly patients are as follows：poor preoperative cardiac and lung function,the primary diseases of lungs,obesity,operative trauma,postoperative pain of incisions,lung infection,inflation of thoracic stomach,fistula of anastomtic stoma and fistula of residual cardia of stomach.