治疗食管、贲门癌术后发生急性呼吸窘迫综合征的体会
The treatment for ARDS follow carcinectomy of esophagus or cardia
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摘要: 为探讨ARDS的防治措施, 本文分析了11例食管、贲门癌术后发生ARDS的发病特点及防治方法。 患者有长期慢性肺部疾患、高龄、高血压病者术后容易发生。 术中对肺组织的损伤及术中, 术后过量输液, 肺部感染及休克, 缺氧可能是术后发生ARDS的重要原因之一。 治疗应积极清除呼吸道分泌物, 辅助通气, 保持气道通畅, 控制肺部感染, 尤其是尽早行气管插管或气管切开为抢救成功的关键。 术前肺功能检查应结合临床来综合分析。
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关键词:
- 急性呼吸窘迫综合征治疗 /
- 食管、贲门癌外科学 /
- 辅助通气治疗
Abstract: To probe for the prophylaxis and treatment for Acute respiratory Distress syndrome(ARDS) folloWing resection of esophageal or cardiac carcinoma, 11 cases were studied. Theresults showed that the patients who had chronic Obstructive pnlmonary diseaes (CVPD), hypertension, senility or somoking for a long time were subject to ARDS, Injury to lung inoperation,overload infusion in and/or after operation, shock or apnea also caused ARDS, The treatment included clearing away respiratory tract secretion, keeping respiratory tractfree assistent ventilation, controlling pulmonary infection, Early executing tracheotomy ortracheointubation was the kempoint in rescuing pationt successfully. Lung function testmust be analysed synthetically with the clinical findings before operation. -
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[1] Milberg JA, Davis DR, Steinberg KP, et al. Improved sur-vival of patients with acute respiratory distress syndrome(ARDS):1983-1993. JAMA, 1995, 273:306. [2] Postlethwait RW, Durbam NC. Complications and deaths after operations for esophageal carcinoma. J Thorac Car-diovasc surg, 1983, 83:827. [3] Shanhian DM, Neptune WB, Ellis FH, et al. Transthoraci-cverse extrathoracic esophagetomy:mortality. morbidity and long-term survival. Ann Thorac surg, 1986, 41:237. [4] 王兴友, 钱桂生, ARDS发病中神经因素的作用. 医学综述, 1996, 2:332. [5] 凌宝存主编, 手术后肺癌并发症. 第1版, 北京:人民卫生出版社, 1994:90～91.
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