食管癌术后急性呼吸衰竭的治疗

分析１０例食管癌术后急性呼吸衰竭的发病特点和治疗。强调高龄、长期吸烟、慢性肺部疾患以及术后有胸内并发症者容易发生。多出现于术后４８－７２ｈ内。除辅助通气外，彻底清除呼吸道内分泌物，控制肺内感染，早期发现并处理胸内其它其它病变是抢救成功的关键。术前肺功能检查需结合临床综合分析。对食管癌术后急性呼吸衰竭，预防比治疗更重要。

Management of Acute Respiratory Failure after Surgery for Esophageal Cancer

Acute respiratory failure (ARF) after operation for esophageal carcinoma is a serious challenge to medical management and usually accompanied by a high mortality rate. This paper present author's experience on the management of 10 such cases. It is emphasized that advanced age, long-history of smoking, COPD are predisposing factors and in-trathoracic surgery and its complication may trigger the ARF,which usually occurs within 48-72 hours after operation. Besides assist mechanical ventilation, thorough clearance of the secretion from the respiratory tract, control of pulmonary infection and early eradication of the intrathoracic complications are the key points of the successful treatment. Preoperative pulmonary functional studies with careful analysis in correlation with patients condition is mandatory especially in elderly patients. Prevention is more important and valuable than treatment for the patients with postoperative acute respiratory failure.