CAJ | 학술논문

目的总结手术治疗胃癌合并重度肺功能障碍患者的临床经验,探讨降低术后并发症的发病率和病死率的有效措施.方法根据用力肺活量、最大通气量、第一秒用力肺活量指标从高到低进行分组,对20例胃癌合并重度肺功能障碍患者术前不同的麻醉方式进行干预,及术前术后给予盐酸氨溴索、多索茶碱、布地奈德、特布他林、异丙托溴铵、噻托溴铵多种药物干预,观察用力肺活量、最大通气量、第一秒用力肺活量变化情况.结果术后2周内,20例胃癌合并重度肺功能障碍患者共出现5种并发症.其中胸腔积液2例,肺部感染2例,呼吸衰竭2例,急性肺水肿1例,急性肺栓塞1例,经积极治疗,19例患者治愈,1例急性肺水肿患者经抢救无效死亡.结论对胃癌合并重度肺功能障碍患者进行术前术后干预是提高手术成功率的关键.
목적 총결수술치료위암합병중도폐공능장애환자적림상경험,탐토강저술후병발증적발병솔화병사솔적유효조시.방법 근거용력폐활량、최대통기량、제일초용력폐활량지표종고도저진행분조,대20례위암합병중도폐공능장애환자술전불동적마취방식진행간예,급술전술후급여염산안추색、다색다감、포지내덕、특포타림、이병탁추안、새탁추안다충약물간예,관찰용력폐활량、최대통기량、제일초용력폐활량변화정황.결과 술후2주내,20례위암합병중도폐공능장애환자공출현5충병발증.기중흉강적액2례,폐부감염2례,호흡쇠갈2례,급성폐수종1례,급성폐전새1례,경적겁치료,19례환자치유,1례급성폐수종환자경창구무효사망.결론 대위암합병중도폐공능장애환자진행술전술후간예시제고수술성공솔적관건.
Objective To summarize the experience of operation on gastric carcinoma combined with severe pulmonary dysfunction and reduce the incidence of postoperative fatality and complications.Methods According to FVC,MVV,FEV1 from high to low grouping,and interfere with ambroxol hydrochloride,doxofylline,budesonide,terbutaline,ipratropium bromide,tiotropium bromide to 20 patients who suffered gastric carcinoma combined with severe pulmonary dysfunction before and after operation,and interfere with different anesthesia methods.Results Postoperative complications occurred in 20 patients within one month,Hydrothorax in 2 cases,pulmonary infection in 2 cases,respiratory failure in 2 cases,acute pulmonary edema in 1 cases,acute pulmonary embolism in 1 case.After active treatment,19 patients cured,1 case died due to acute pulmonary edema.Conclusion The complications rate and risks are high in the gastric carcinoma patients combined with severe pulmonary dysfunction,and strict preoperative and postoperative managements are key to the operation.