高龄肺癌患者术后呼吸衰竭的临床分析

目的探讨高龄肺癌患者术后易发生呼吸衰竭的因素及防治效果。方法分析年龄≥70岁肺癌患者术后发生呼吸衰竭的17例(呼衰组)和同期未发生呼吸衰竭的101例(对照组)的临床资料，探讨可能导致呼吸衰竭的因素，比较治疗效果。结果吸烟指数高低．术前合并症，肺功能状况，手术方式，病理分期，肺内感染出现时间与术后呼吸衰竭的发生有明显关系；呼吸衰竭发生率14．41％，救活成功率76．48％。结论术前戒烟、锻炼呼吸功能、积极调整合并症、预防性应用抗生素、减少术中出血和减轻手术创伤对预防高龄肺癌患者术后呼吸衰竭发生有重要意义；有效控制肺内感染、及时给予机械通气是救治成功的最有效措施。

Clinical analysis of postoperative respiratory failure in elderly patients with lung caner

Objective To investigate the factors and prevention and treatment of postoperative respiratory failure in the elderly patients with lung caner.Methods Clinical data of 17 lung cancer cases who were more than 70 years old with postoperative respiratory failure (respiratory failure group) and 101 cases without postoperative respiratory failure (control group) were analyzed.The factors resulting in the postoperative respiratory failure were investigated and the therapeutic effects were compared.Results Smoking index,preoperative complication,lung function,operative methods,pathological staging,and lung infective time were obviously correlated with the postoperative respiratory failure.The incidence rate of postoperative respiratory failure was 14.41% and the success rate of treatment was 76.48%.Conclusion Preoperative non-smoking,exercise of respiratory function,control of complication,preventive use of antibiotics,reducing of intraoperative bleeding and operative trauma can prevent from postoperative respiratory failure in the elderly patients.Effective controls of infection and timely mechanical ventilation are the most effective way to treat postoperative respiratory failure.