肺切除术后呼吸衰竭的原因与治疗

目的探讨肺切除术后呼吸衰竭的原因、预防及治疗。方法回顾性分析我院1999年1月~2004年10月肺切除术后发生呼吸性衰竭的患者21例,机械通气治疗19例,其中气管切开11例。另2例经面罩吸氧,纤维支气管镜吸痰后症状缓解。结果术后呼吸衰竭发生率为4.9%(21/422),死亡率19%(4/21)。结论高龄、长期吸烟、慢性支气管炎病史、呼吸道感染、手术创伤、伤口疼痛刺激、术前心肺功能异常是诱发呼吸衰竭的原因;加强围手术期呼吸道管理,避免术后并发症是预防术后呼吸衰竭的关键;尽早诊断,及时进行机械通气是抢救成功最有效的手段。

STUDY ON RESPIRATORY FAILURE AFTER PNEUMOHECTOMY

Objective To explore the causes,prvention and treatment of respiratory failure after pneumohectomy.Methods 21 cases of respiratory failure after pneumohectomy were treated in this hospital from January 1999 to October 2004.(9 cases of them received mechanical ventilation,including tracheotomy in 11 cases.Two other cases received oxygen inhalation through masks and got remission after sputum removal through fiberbronchoscope.Results The incidence of respiratory failure after pneumohectomy was 4.9%(21/422) and the death rate was 19%(4/21).Conclusion The causes of respiratory failure were found to be old age,long-time smoking,chronic bronchitis,operative trauma,stimuli caused by wound pains and cardiopulmonary abnormity.The best way to rescue them is early diagnosis and timely mechanical ventilation of oxygen.