摘要
目的 探讨食管癌术后发生呼吸衰竭 (RF)的高危因素。 方法 将我院胸心外科 1985～ 1998年收治的食管癌术后发生 RF的 5 8例患者临床资料 ,与按 1∶ 2比例随机抽取的同期手术后未发生 RF的 116例食管癌患者的资料做对照 ,用 χ2检验比较两组患者的术前肺功能 ,术前、术后其它合并症 ,吻合口部位 ,手术当天静脉液体入量和患者年龄、吸烟量的差异 ,应用 L ogistic回归分析肺功能各异常指标与术后 RF发生的相关强度 ,推测可能导致食管癌术后 RF发生的高危因素。 结果 RF组的最大通气量 (MVV) ,残气容积 /肺总量比值 (RV/TL C) ,第一秒用力呼气容积 (FEV1 ) ,最大呼气流量 (PEF) ,75 %肺活量最大呼气流量 (V75 )以及肺一氧化碳弥散量明显差于对照组 (P<0 .0 1) ;手术当天 (含术中 )静脉晶体液入量和输血量明显高于对照组 (P<0 .0 1) ,RF组术后其它并发症发生率和颈部吻合率明显高于对照组 (P<0 .0 1)。 结论 术前肺功能提示重度慢性支气管炎、肺气肿及吻合口瘘等术后并发症是术后发生 RF的高危因素 ,对颈部吻合患者应加强呼吸功能监护 ,术中严密止血是预防术后 RF发生的重要环节之一。
Objective\ To analyze the risky factors of post operative respiratory failure in esophageal cancinoma patients.\ Methods\ Fifty eight patients with respiratory failure (respiratory failure group) after esophagectomy and 116 controls (control group) were studied. Preoperative respiratory function, the other complications, the site of anastomsis, intravenous infusion, and age of patients between two groups were compared by χ 2 analysis and Logistic Regression.\ Results\ Maximum ventilatory volume(MVV), residual volume/total lung capacity(RV/TLC), forced expiratory volume in 1 second (FEV 1), peak expiratory flow(PEF), velocity at 75% vital volume(V 75 ) and diffusion capacity of the lung for carbon monoxide in respiratory failure group was significantly worse than those of control group( P<0.01) . The venous input, the frequency of esophagogastrostomy at neck were significantly more in respiratory failure group( P<0.01) . There was no significant difference in two groups in terms of breathing reserve(BR), V 25 and tuberculosis history( P>0.05) .\ Conclusion\ Massive venous input, esophagogastrostomy at neck and severe chronic obstructive pulmonary disease are the risky factors of post operative respiratory failure in esophageal cancinoma patients.
出处
《中国胸心血管外科临床杂志》
2000年第2期92-94,共3页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
关键词
食管癌
外科手术
呼吸衰竭
高危因素
Esophageal carcinoma Post operation Respiratory failure Risky factor
