102例老年食管癌术后呼吸功能不全的临床诊疗分析

目的:探讨老年食管癌术后呼吸功能不全的危险因素。方法:对102例老年食管癌术后呼吸功能不全的临床资料做回顾性分析。结果:在102例老年食管癌术后呼吸功能不全患者中,34例发生呼吸衰竭(占33.3%),12例死亡(占呼吸衰竭病例数的35.3%,占呼吸功能不全病例数的11.8%)。术后呼吸功能不全发生时间:从手术结束麻醉苏醒后不能脱呼吸机至术后10天,其中呼吸衰竭多发生于发生呼吸功能不全6~12小时后。呼吸衰竭患者应用呼吸机治疗时间为2~27天。结论:术前心肺功能较差、肺部原发疾病、术中输入较多晶体液、术中大量输血、手术创伤、术后切口疼痛、肺部感染、胸胃扩张、吻合口瘘、胃贲门残端瘘等与老年食管癌术后呼吸功能不全有关。

Diagnosis and treatment of esophageal carcinoma in old patients postoperative respiratory dysfunction

Objective:To study the risk factors related to postoperative respiratory dysfunction in old patients with esophageal carcinoma. Methods: Retrospecitive analysis was performed on clinical data of 102 old patients with respiratory dysfunction after esophageal carcinoma resection . Results: Among 102 old patients with postoperative respiratory dysfunction, 34cases(33.3%) developed respiratory failure and 12 cases dead . whten respiratory dystunction took place,as ranged from when the tracheal tube could not be taken away smoothly postanesthesisa to 10 days after operation. Respiratory failure took place 6 to 12 hours after respiratory dysfunction mostly and the period of ventilator using ranged from 2 days to 27 days.Conclusion: The main factors causing postoperative respiratory dysfunction in old patients with esophageal carcinoma are as follows: poor preoperative cardiac and lung function, the primary diseases of lungs, electrolyte solution overperfusion or much more transfusion, operative trauma, postoperative pain of incisions, lung infection, inflation of thoracic stomach, fistula of anastomotic stoma and fistula of cardia of stomach etc.