肺减容术肺功能对围术期的影响

Lung volume reduction surgery the pulmonary function affect to the perioperative period

目的 回顾性分析总结 2 3例肺大疱肺减容术病人肺功能对围术期的影响和治疗经验。方法 通过通气障碍程度、围术期血气分析的观察 ,分析手术的适应症、肺减容术的范围、围术期应采取的措施。结果 2 3例肺减容术病人 ,单肺叶手术 15例 (15 / 2 3) ,多肺叶手术 8例 (8/ 2 3) ,慢支肺气肿病人 19例 (19/ 2 3) ,术后应用呼吸机 13例 ,发生呼吸衰竭 4例 ,全组病人无死亡。术后呼吸衰竭的发生与肺功能障碍程度、手术范围、抗菌素的应用关系密切。结论 肺减容手术可改善病人呼吸功能 ,适当的选择手术指征 ,强化呼吸道管理 ,合理使用呼吸机可减少呼吸衰竭的发生。

Objective Retrospectively analyzes 23 patiments with pulmonary bulla do lung volume reduction surgery.The pulmonary function affect to the perioperative period and treat experience.Methods To observe the degree of ventilate disturbance and pulmonary function in the perioperative period.Analysis indication of the operation,range of the lung volume reduction surgery,method of the application in the perioperation period.Results 23 patients in lung volume reduction surgery.Unilobe of lung was operation 15 cases 15/23,polylobes of lungs operation was 8 cases 8/23.The patients with chronic bronchitis pulmonary emphysema 19 cases 19/23.13 patients use the respirator.Respiratory failure 4 cases.All patients was no died.The postoperative respiratory failure was significantly correlated with degree of preoperative impaived pulmonary function and the extent of operation and the use of prophylactic antibiotics.Conclusion The lung volumew reduction surgery can improve respiratory function.The operation indication was correct to choose.Intensive management in the respiratory tract.Rational use respirator can reduce morbidity of respiratory failure.