CAJ | 학술논문

目的：探讨食管癌根治术后患者再次气管插管的病因及预防再插管损伤的措施。方法回顾性分析2012年1月至2013年12月收治的470例施行食管癌根治术的患者中14例术后再次气管插管的临床资料与转归。结果再次气管插管14例，占全组患者的2?98％（14／470）；术后气管插管拔除至再次气管插管的时间间隔为0?5～360 h，中位间隔时间为50 h；其中因呼吸功能衰竭需再次气管插管10例，占71?4％（10／14）；再次气管插管后救治成功9例，成功率为64?3％（9／14）。结论重症呼吸功能衰竭是食管癌根治术后患者再次气管插管的主要病因；预防再次气管插管以及避免其次生风险的关键在于预防各种术后并发症。
목적：탐토식관암근치술후환자재차기관삽관적병인급예방재삽관손상적조시。방법회고성분석2012년1월지2013년12월수치적470례시행식관암근치술적환자중14례술후재차기관삽관적림상자료여전귀。결과재차기관삽관14례，점전조환자적2?98％（14／470）；술후기관삽관발제지재차기관삽관적시간간격위0?5～360 h，중위간격시간위50 h；기중인호흡공능쇠갈수재차기관삽관10례，점71?4％（10／14）；재차기관삽관후구치성공9례，성공솔위64?3％（9／14）。결론중증호흡공능쇠갈시식관암근치술후환자재차기관삽관적주요병인；예방재차기관삽관이급피면기차생풍험적관건재우예방각충술후병발증。
Objective To investigate the pathogenesis of reintubation in patients undergoing esophagectomy and analyze the preventive measures of reintubation. Methods From January 2012 to December 2013, 470 patients with esophageal carcinoma were performed surgery in our department. Among them 14 patients were reintubated after esophagectomy. Their clinical data and prognosis were retrospectively analyzed. Results 14 cases of 470 patients were reintubated, accounting for 2?98%( 14/470) . From endotracheal tube removal after surgery to reintubation, the time interval were 0?5 to 360 hours, with a median time of 50 hours. 10 cases received reintubation due to respiratory failure, accounting for 71?4%( 10/14) . Of 14 patients who received reintubation, 9 cases were survived. Successful treatment rate was 64?3%( 9/14) . Conclusion Respiratory failure is the major cause of reintubation in patients who under?going esophagectomy. Prevention and timely treatment of postoperative complications may avoid reintubation and its secondary injuries.