高龄开胸患者围手术期的临床处理体会

The experience of perioperative treatment of thoracic operation in aged patients

目的:探讨高龄开胸患者围手术期的临床处理方法。方法:对28例在全麻下行开胸高龄患者的临床资料进行回顾分析。结果:28例出现术后并发症15例(53.57%),其中低血氧饱和度3例,肺炎肺不张7例,心律失常4例,吻合口瘘1例。患者术前年龄、肺部疾病、心血管疾病、糖尿病、吸烟和脑梗死对术后并发症均无明显影响(P>0.05)。结论:高龄患者术后并发症发生率较高,但高龄并非是胸部手术的禁忌证,术前需积极治疗相关疾病;术中麻醉需安全,尽量减少对心肺等重要脏器的干扰;术后需加强呼吸道管理,防止相关并发症的发生。

Objective： To explore the perioperative clinical treatment of thoracic operation in aged patients. Methods： The clinical data of 28 patients treated with thoracic operation were retrospectively analyzed. Results： Postoperative complications were found in 15 cases（ 53.57%）,which included low oxygen saturation in 3 cases,atelectasis and pulmonary infection in 7 cases,arrhythmia in 4 cases and anastomotic fistula in 1 case. The preoperative patient age,lung and cardiovascular disease,diabetes,smoking and cerebral infarction did not have significant effects on the postoperative complications（ P〉0.05）. Conclusions： The incidence of postoperative complications in aged patients is high,but old age is not the contraindication of chest surgery. Active treating preoperative diseases,intraoperative safe anesthesia,reducing the damage to the heart and lung as far as possible and strengthening the postoperative respiratory tract management can prevent the occurrence of complications.