摘要
选择１９９２年６月至１９９５年６月伴重度肺功能减退的胸部手术病人３５例（肺癌１６例，食管癌、贲门癌１９例），以评价重度肺功能减退对胸部手术的影响。术前检测ＭＶＶ＜５０％３２例，＜４０％１８例；ＦＥＶ１＜５０％３０例，＜４０％２２例；ＦＶＣ＜６０％２６例，＜５０％１１例。结果全组手术成功率在８２％以上，并发急、慢性呼吸衰竭各４例，死亡６例。死亡病例中，ＭＶＶ均＜５０％，其中４例＜４０％；ＦＥＶ１均＜５０％，其中４例＜４０％；ＦＶＣ＜６０％５例，＜５０％４例。作者认为，对适于胸部手术的重度肺功能减退病人应确定界限值：ＦＶＣ在６０％以上，ＭＶＶ和ＦＥＶ１两项中至少有一项在４０％以上。另外，必要的术前准备、重视麻醉及术中操作、术后呼吸管理和治疗，大部分重度肺功能减退病人是能够耐受胸部手术的。
Objective:To evaluate the influence of poor pulmonary function on the risk of intrathoracic operation.Clinical material and method:35 patients with very poor pulmonary function undergoing intrathoracic operation were chosen for study.Their surgical pathology included lung carcinoma in 16 cases and esophageal and gastric cardial carcinoma in 19.Pulmonary functional tests demonstrated MVV <50% in 32 patients,<40% in 18;FEV1.0 <50 in 30 patients and <40% in 22;FVC <60% in 26 patients,<50% in 11.Results:Postoperative acute and chronic respiratory failure occurred in 4 patients respectively,resulting in 6 deaths giving a mortality rate of 17%.Conclusion:The data indicate that for patients with very poor pulmonary function,criteria for intrathoracic operation should be critically scrutinized.Their FVC should be higher than 60% and MVV or FEV1.0 higher than 40%.Cautious preoperative preparations,good choice and practice of anesthesia,gentle operative technique with least amount of pulmonary trauma,thorough perioperative toiletting of the respiratory tract and early treatment of pulmonary complications may help the patients survive the intrathoracic operation.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
1997年第6期346-348,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
