机械通气在高龄低肺功能食管癌患者术后的临床应用

目的探讨机械通气在高龄肺功能低下食管癌术后的应用价值。方法选取56例术前肺功能(MVV≤50%和FEV1/FVC>45%)低下的食管癌患者,年龄(72.3±4.1)岁。其中术后行呼吸机辅助呼吸的37例为A组;术后常规治疗,未行呼吸机辅助呼吸的19例为B组。观察两组患者血氧饱和度、心律失常、动脉血气以及住院时间等情况。结果两组患者均无死亡病例。A组中脉搏血氧饱和度(97.6±1.4)%,心律失常发生率29.7%(11/37),呼吸机辅助呼吸时间(33.2±5.4)h,术后住院时间(7.6±2.3)d;B组中脉搏血氧饱和度(92.4±1.2)%,心律失常发生率47.4%(9/19),术后住院时间(10.1±3.1)d,其中2例因血氧饱和度降至80%,立刻行呼吸机辅助呼吸;两组术后血气的变化差异有统计学意义。结论对于肺功能低下的食管癌手术患者,应用机械通气辅助呼吸可扩大手术适应证,减少术后并发症。

The clinical application of mechanical ventilation with esophageal carcinoma in the eldly and lower pulmonary function patients

Objective To explore the applied value of mechanical ventilation with esophageal carcinoma in the eldly and lower pulmonary function patients.Methods 56 patients(average age:72.3±4.1)with esophageal carcinoma and lower pulmonary function(MVV≤50%,FEV1/FVC>45%) were divided into 2 groups: Group A,37 patients were treated with assisted respiration after operation.Group B,19 patients weren't treated with assisted respiration after operation.We observe the SPO2,arrhythmia,arterial blood gas and postoperative length of stay in 2 groups,and record the time of assisted respiration in group A.Results All patients weren't dead.The patients in A group,SPO2 was(97.6±1.4)%,the incidence rate of arrhythmia was 29.7%(11/37),the time of assisted respiration was(33.2±5.4)h,postoperative length of stay was(7.6±2.3)d.In B group,SPO2 was(92.4±1.2) %,the incidence rate of arrhythmia was 47.4 %(9/19),postoperative length of stay was(10.1±3.1)d.SPO2 decreased to 80% and treated with assisted respiration in 2 cases.There was a significant difference in SPO2,the incidence rate of arrhythmia,postoperative length of stay and arterial blood gas.Conclusion It is a better way to enlarged the indication of surgical treatment and reduce the postoperative complications by using mechanical ventilation in patients with esophageal carcinoma and lower pulmonary function.