胸部肿瘤手术病人围手术期血气分析及临床意义.docVIP

胸部肿瘤手术病人围手术期血气分析及临床意义【中图分类号】R655 【文献标识码】A 【文章编号】1672－3783(2011)12－0061－01 【摘要】目的 探讨动脉血气分析检测在胸部肿瘤病人围手术期的应用及其临床意义.。方法 分别检测胸部肿瘤病人术前一周内，术后2小时，8小时以及第1，２，３,４天的动脉血气，对所检测数据进行统计学处理并结合临床各种术后并发症进行分析。结果 胸部肿瘤病人手术后第二天动脉血氧分压最低，二氧化碳分压最高，低氧血症造成术后各类心肺并发症的发生率也高。结论 围手术期血气分析的变化与术后各类并发症的发生有关，为减少各类术后并发症的发生和保证围手术期的安全应在术后三天内应给予充分的氧疗并保持呼吸道通畅，必要时应用呼吸机辅助呼吸 【关键词】胸部肿瘤 血气分析 临床意义 【Abstracts】Objective:To discuss the application of the artery analysis on blood gases examination on the tumour-- on―thoracic―part patients and its clinical signification. Method: Respectively examine tumour―on―thoracic part patients , artery analysis on blood gases at different time like within a week , 2 hours after the operation and 8 hours , and on the first, second , third and fourth day, then make some analysis on the examined data combining the all kinds of clinical postoperative syndrome. Result:On the second after the operation , artery blood oxygen partial pressure is the lowest, carbon dioxide partial pressure is the highest and the incidence rate of all kinds of heart and lung syndrome caused by hyposemia is also higher Conclusion:Change of the artery analysis on blood gases closiong to the operating time is relative to the happening of all kings of syndromes. In order to reduce it and make sure of the safety of the operation, patients should be given adequate oxygen treatment to keep respiratory tract working normally three days after the operation. If necessary, the breathing machine should be used for help their breath. 【Keywords】tumour on the thoracic part artery analysis on blood gases Clinical signification 胸部肿瘤外科手术风险大，开胸手术又可使病人出现低氧血症［1］，使围手术期并发症的发生率增高，围手术期监测病人的血气分析，有助于及时处理低氧血症和呼吸功能不全，防止各类并发症的发生，现将我们2008年9月至2011年8月73例围手术期血气监测结果结合临床并发症发生的情况分析如下 1 临床资料 1.1 一般资料:本组73例，男性61例，女性12例，年龄45－88岁，中位年龄64.2岁，吸烟率为56.4％，手术前检查发现肺功能障碍45例，占61.6％。其中阻塞性通气功能障碍12例，限制性通气功能障碍 24例，混合性通气功能障碍9例。合并心脏疾病者22例，占30.%，其中传导阻滞9例，心率不齐5例，左心室肥大或T波改变8例。术前诊断食管贲门癌症45例，肺癌28例。肺癌手术切除28例，其中全肺切除1例，肺叶切除23例，楔型切除4例。食管贲门癌切除43例