食管贲门癌术后支气管肺炎的防治

本文报告４６４１例食管、贲门癌术后３４例支气管肺炎的临床资料，其发生率为０．７３％，死亡率为４４．１％。本组资料表明：病人年龄大、手术时间长和手术操作对支气管肺组织的损伤是支气管肺炎发生的主要原因，而支气管和肺组织原有病变是其主要诱因。粘液脓性或脓痰、肺部湿性罗音、肺部Ｘ线表现和纤支镜下支气管粘膜的病理改变是可靠的诊断依据。本文讨论了治疗方法和效果，认为对疾多粘稠、咳痰无力的病例，尽早行气管插管住以机械辅助呼吸，能够改善肺的通气功能，增加血氧饱和度，降低死亡率。本文还讨论了一些预防措施。

The Prevention and Management of Bronchopneumonia after Removing Carcinomas of the Esophagus and Gastric Cardia

This article reports the clinical materials of 34 cases of bronchopneumonia after thoracotomy in 4641 patients,who suffered from carcinoma of the esophagus and gastric cardia.Theoverall morbidity rate of the complication was 0.73% and the mortality rate was 44%.Through analysing the clinical materials,the authors considered that the main causes of bronchopneumonia after operation were old age,a long operative time,and injury to the bronchiand the lungs during operation. The main predisposing causes were the primary broncho-pulmonary diseases.The dependable diagnostic bases of the complication were that the patientshad mucopurulent or purulent sputum,moist raies in chest auscultation,the appearances inchest film and the pathologic changes of the bronchi mucosa under fiberoptic bronchoscopy.The management and results of the complication were discussed.The authors considered that for the patients who had heavy ropy sputum or couldn't cough effectively,it wasnecessary to make early tracheotomy and give assistant pressor artificial respiration,whichcould improve the pulmonary ventilation,increase the degree of blood oxygen stauration anddecrease the mortality rate. Some preventive measures of the complication are also discussedin the article.