食管癌放疗后根治性切除术后肺部严重并发症的防治

本文报告1979年10月～1987年9月245例食管癌根治切除术。术后严重肺并发症发生率术前放疗组为9.4％(5/52),单纯手术组为1.5％(3/193) (P<0.01)。作者根据大体观察、肺活检及临床过程分析认为:在肺受潜在放射性损伤后,手术中机械性压迫和纵隔淋巴结清扫所致的肺淋巴阻滞,可诱发放射性肺炎。文中对本病的诊治及预防进行了探讨。

Prevention and Treatment of Serious Pulmonary Complications Following Irradiation and Radical Resection for Cancer of Esophagus

Out of a series of 254 cases of cancer of the esophagus,serious pulmonary complication occurred in 9.4%(5/52) of patients who had received radiotherapy before radical resection,and in 1.5%(3/193) of patients without radiotherapy prior to resection.There was significantly higher incidence of pulmonary complication in the former group (P<0.01). Macroscopic,microscopic as well as clinical observations revealed that on the basis of potential irradiation injury of the lung,the anatomical damage caused by surgical manipulation and the lymphatic stasis resulting from dissection of the mediastinal lymph nodes might be conducive to radiation pneumonia or even ARDS.