肺癌全肺切除术后常见并发症临床分析-第三军医大学学报.docVIP

肺癌全肺切除术后常见并发症临床分析 张 竞，王云喜，初向阳，薛志强，刘 毅*（100853 北京解放军总医院医院胸外科1月至2011年10月施行全肺切除手术的155例肺癌患者的临床资料，统计患者年龄、术前夹杂病史、肺功能、术后带管时间及术后住院时间等指标。结果 本组术后共发生各类并发症40例，占25.81％，其中心律失常20例；肺部感染13例；急性呼吸衰竭1例；肺栓塞3例；支气管胸膜瘘2例；术后胸腔内活动性出血1例。全组围手术期死亡5例，手术死亡率3．23％，其中3例考虑为肺栓塞引起死亡，其余2例为术后肺部感染导致呼吸衰竭死亡。结论 肺癌全肺切除是一种高风险术式，其术后并发症及死亡率较肺叶切除更为常见（问题1：请重写，直接写出常见并发症，才能与目的呼应）。对拟行全肺切除的患者，要严格掌握手术适应证，术前检查应更加全面准确；术后加强围手术期管理，严密监护，做到及时、正确的处理。 [关键词]肺癌；全肺切除术；手术后并发症 [中图法分类号] [文献标志码] A [通作者，@163.com An analysis of common complications after pneumonectomy for lung cancer Zhang Jing，W Yunxi，C Xiangyang，Liu Yi (Department of Thoracic Surgery Chinese PLA General Hospital，Beijing 100853，China) [Abstract] Objective To summarize and discuss factors, prevention and dealing of common complications following pneumonectomy due to lung cancer. Methods A total of 155 patients of lung cancer underwent pneumonectomy in our department during the time period of January 2009 to October 2011. A retrospective analysis of their clinical data was conducted, including age, preoperative medical history, lung function, postoperative intubation time and postoperative hospital stay. Results Complications occurred in 40 cases, accounting for 25.81%. These were arrhythmia in 20 cases, lung infection in 13 cases, acute respiratory failure in 1 case, pulmonary embolism in 3 cases, bronchopleural fistula in 2 cases, and postoperative intrathoracic active bleeding in 1 case. Five patients died in perioperative time, and the surgical mortality was 3.22% The causes of death were probably pulmonary embolism for three, respiratory failure following postoperative pulmonary infections in two. Conclusion Pneumonectomy for lung cancer patients is a high-risk surgical procedure, and postoperative complications and death are likely to happen compared with lobectomy. Dealing with patients who are about to take pneumonectomy, it should strictly adhere to the surgical indications. Before operation, comprehensive and accurate examinations are a must;