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中华胸部外科电子杂志 ›› 2015, Vol. 02 ›› Issue (04) : 241 -244. doi: 10.3877/cma.j.issn.2095-8773.2015.04.007

所属专题: 文献

论著

高龄食管癌患者术后肺部并发症的防治
杜杰1, 张绍明2, 徐小平2, 陈界, 汪雷2,()   
  1. 1. 200030 上海市徐汇区枫林街道社区卫生服务中心
    2. 200030 上海,解放军第四五五医院心胸外科
  • 收稿日期:2015-10-20 出版日期:2015-11-28
  • 通信作者: 汪雷

Prevention and treatment of postoperative pulmonary complications after esophagectomy in elderly patients with esophageal carcinoma

Jie Du1, Shaoming Zhang2, Xiaoping Xu2, Jie Chen, Lei WANG2,()   

  1. 1. Fenglin Community Health Service Center of Xuhui District, Shanghai 200030, China
    2. Department of Cardiothoracic Surgery, the 455th Hospital of PLA, Shanghai 200052, China
  • Received:2015-10-20 Published:2015-11-28
  • Corresponding author: Lei WANG
  • About author:
    Corresponding author: Wang Lei, Email:
引用本文:

杜杰, 张绍明, 徐小平, 陈界, 汪雷. 高龄食管癌患者术后肺部并发症的防治[J/OL]. 中华胸部外科电子杂志, 2015, 02(04): 241-244.

Jie Du, Shaoming Zhang, Xiaoping Xu, Jie Chen, Lei WANG. Prevention and treatment of postoperative pulmonary complications after esophagectomy in elderly patients with esophageal carcinoma[J/OL]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2015, 02(04): 241-244.

目的

探讨高龄食管癌患者术后并发症的防治策略。

方法

回顾性分析41例高龄(≥70岁)食管癌患者的临床资料。根据术前综合评估情况选择手术方式:其中行食管癌根治、胃代食管吻合术29例(右胸上腹二切口14例,颈胸腹三切口9例,左胸切口4例,左胸腹联合切口2例),行食管癌切除、颈段食管外置12例。术后加强呼吸道管理,及早发现并积极处理肺部并发症。

结果

围手术期肺栓塞1例,继发多脏器功能衰竭死亡。术后发生肺部感染2例,肺不张2例,呼吸功能衰竭3例。

结论

细致的术前评估和准备、管状胃重建消化道、积极有效的呼吸道管理是术后肺部并发症防治的关键。

Objective

To explore the prevention and treatment measures of postoperative pulmonary complications after esophagectomy in elderly patients with esophageal carcinoma.

Methods

The clinical data of 41 elderly patients with esophageal carcinoma were retrospectively reviewed with respect to the general conditions, cardiopulmonary function, tumor grade and scheduled protocols of surgical intervention. Of the 41 patients, 29 underwent esophagogastrostomy(right chest, upper abdomen incision in 14; neck, chest and abdomen incision in 9; single left chest incision in 4; and left thoracoabdominal incision in 2). The other patients received esophagectomy and cervical esophageal externalization. Postoperative pulmonary complications were treated timely.

Results

One died of multiple system organ failure followed by pulmonary embolism. There were 2 cases of pulmonary infection, 2 cases of atelectasis and 3 cases of respiratory failure.

Conclusions

Cautious preoperative assessment, gastric tube reconstruction and respiratory management are crucial steps in prevention and treatment of postoperative pulmonary complications after esophagectomy in elderly patients with esophageal carcinoma.

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