肺癌、食管癌切除术后24小时内死因探讨──附8例分析

我院自１９７７年４月至１９９２年７月共行肺癌、食管癌、贲门癌切除２０１８例（肺癌切除３２６例，食管，贲门癌切除１６９２例），手术后２４小时内死亡８例，占上述全部切除病例的０．３９％（８／２０１８）其中食管贲门癌６例占０．３６％（６／１６９２），肺癌手术的２例，占０．６％（２１／３９６）。８例中男７例，女１例，年龄３２岁～６５岁，这些病例术前各项检查基本正常，８例中，除１例经尸体解剖明确为吻合口小动脉出血性休克死亡外，余７例均考虑为循环或呼吸衰竭所致，讨论其原因一为患者本身心肺功能储备力不足，大手术后多种因素发生了不可逆的变化，一为医护方面观察，抢救多因素失误，由于无尸体解剖，仅为临床推断，特报告供总结经验、吸取教训之用。

Discussion of death cause within 24 hours after resection of Lung and esophageal cancer -An analysis of 8 Cases

Abstract cases of resection of lung cancer and esophagealeardiac carcinoma (lung cancer 326,esophago-cardiac cancer 1692) have been performed in our hospital from April, 1977 to July, 1992.Eight patients died within 24 hours after operation, death rate accounts for 0. 39 Percent(8/2018) totally. Seven patients died of resection of esophago-cardiac carcinoma, death rate makes up 0. 41 percent(7/1692). One patient died of operation resection of lung cancer, death rate amounts to 0. 3 Percent(1 /326).The results of preoperative examination for these eight patients were found to be within normal range.One patient was found to die of hypovolumerie shock because of bleeding of arterioles in anastomosis after autopsy. The death cause of other patients was proposed as either eirculatory or respiratory failure or comdined railure. Due to lack of autopsy the death causes we conjectured clinically were as following: (1) Patients' cardiac and Pulmonary Patent capacity is very Poor, so these Patients cann't tolerate the operation.(2) Lack of strict observation and optimal management after operation The paper is presented to sum up our experience and draw a lesson from our work.