70岁以上老年人开胸手术的围手术期处理

The perioperative treatment of thoracic surgery in aged patients over 70 years old

目的探讨老年人开胸手术期的处理。方法总结46例70～84岁老年人围手术期的临床经验。结果术后并发心律失常31例，心功能不全7例，腔隙脑梗塞1例，肾功能不全1例，肝功能不全1例，均有不同程度的ALI，其中9例符合ARDS，应用容许性高碳酸血症机械通气治疗而愈。结论老年人开胸手术并存症、并发症高，术前必须最大限度的改善患者的全身情况，对麻醉、手术及术后处理均提出较高要求，尤以心肺并发症为术后防治重点，容许性高碳酸血症机械通气治疗在一定程度上改善了ARDS患者的预后。

To analyze perioperative treatment of thoracic surgery in aged patlents. Methods The clinical experience of preoperation, perioperation and postoperation of 46 patients over 70 years old were studied. Results Postoperative complication occurred,such as 31 cases of arrhyth mia, 7 cases of heart failures,one case of cerebral lacuna infarction,one case of renal dysfunction,one case of hepatic dysfunction All of patients have had ALI, 9 developed ARDS,one of whom died. Con cIusion Complications occured more frequently in aged patients, The patient's biophysical and pathophysical conditions have to be carefully prepared to meet the perioperative demands,especially heart and lung functions; Perrnissive hypercapnia mechanical ventilation therapy improves the prog nosis of ARDS patients in some degree.