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1、肺癌全肺切除术后常见并发症临床分析张竞，王云喜，初向阳，薛志强，刘毅*（100853北京，解放军总医院医院胸外科）[摘要]目的总结肺癌全肺切除术术后常见并发症，讨论其预防及处理方法。方法回顾性分析我科2009年1月至2011年10月施行全肺切除手术的155例肺癌患者的临床资料，统计患者年龄、术前夹杂病史、肺功能、术后带管时间及术后住院时间等指标。结果本组术后共发生各类并发症40例，占25.81％，其中心律失常20例；肺部感染13例；急性呼吸衰竭1例；肺栓塞3例；支气管胸膜瘘2例；术后胸腔内活动性出血1例。全组围手术期死亡5例，手术死亡率3．23％，其中3例考虑为肺栓塞引起死亡，其余2
2、例为术后肺部感染导致呼吸衰竭死亡。结论肺癌全肺切除是一种高风险术式，其术后并发症及死亡率较肺叶切除更为常见（问题1：请重写，直接写出常见并发症，才能与目的呼应）。对拟行全肺切除的患者，要严格掌握手术适应证，术前检查应更加全面准确；术后加强围手术期管理，严密监护，做到及时、正确的处理。[关键词]肺癌；全肺切除术；手术后并发症[中图法分类号][文献标志码]A[通信作者]刘毅，E-mail:alydsj@163.comAnanalysisofcommoncomplicationsafterpneumonectomyforlungcancerZhangJing，WangYunxi，ChuXi
3、angyang，XueZhiqiang,LiuYi(DepartmentofThoracicSurgeryChinesePLAGeneralHospital，Beijing100853，China)[Abstract]ObjectiveTosummarizeanddiscussfactors,preventionanddealingofcommoncomplicationsfollowingpneumonectomyduetolungcancer.MethodsAtotalof155patientsoflungcancerunderwentpneumonectomyinourdepa
4、rtmentduringthetimeperiodofJanuary2009toOctober2011.Aretrospectiveanalysisoftheirclinicaldatawasconducted,includingage,preoperativemedicalhistory,lungfunction,postoperativeintubationtimeandpostoperativehospitalstay.ResultsComplicationsoccurredin40cases,accountingfor25.81%.Thesewerearrhythmiain2
5、0cases,lunginfectionin13cases,acuterespiratoryfailurein1case,pulmonaryembolismin3cases,bronchopleuralfistulain2cases,andpostoperativeintrathoracicactivebleedingin1case.Fivepatientsdiedinperioperativetime,andthesurgicalmortalitywas3.22%Thecausesofdeathwereprobablypulmonaryembolismforthree,respir
6、atoryfailurefollowingpostoperativepulmonaryinfectionsintwo.ConclusionPneumonectomyforlungcancerpatientsisahigh-risksurgicalprocedure,andpostoperativecomplicationsanddeatharelikelytohappencomparedwithlobectomy.Dealingwithpatientswhoareabouttotakepneumonectomy,itshouldstrictlyadheretothesurgicali
7、ndications.Beforeoperation,comprehensiveandaccurateexaminationsareamust;Afteroperation,perioperativemanagementandintensivecareshouldbeenhancedsoastoreducetheincidenceofcomplicationsandhazardsfollowingpneumonectorybymeansofdelivert
