目的　探讨合并慢性阻塞性肺疾病 (CPOD)的食管癌病人的围手术期处理。方法　总结2 18例合并COPD病人行食管癌根治术的手术经验和术后急性呼吸窘迫综合征 (ARDS)的治疗体会。结果　全组无手术中死亡。吻合口漏致全身感染死亡 2例 ,术后发生ARDS 2 6例 ,死亡 7例。结论　术前严格的检查有助于判断COPD程度 ,及早发现和及时处理是ARDS治疗成功的关键 ,除病因治疗和脏器功能维持外 ,更重要的是以全身炎症反应综合征 (SIRS)与代偿性抗炎反应综合征 (CARS)为主线 ,积极干预 ,可提高成功率 Objective To investigate the perioperative management of esophageal cancer patients with chronic obstructive pulmonary disease (CPOD). METHODS: The surgical experience of esophageal carcinoma radical resection in 218 patients with COPD and the experience of postoperative acute respiratory distress syndrome (ARDS) were summarized. Results No death occurred in the entire group. Anastomotic leakage caused death of systemic infection in 2 patients. Postoperative ARDS occurred in 26 patients and 7 patients died. Conclusion Preoperative strict examination can help to determine the degree of COPD. Early detection and timely treatment are the key to successful ARDS treatment. In addition to etiological treatment and organ function maintenance, the more important is the systemic inflammatory response syndrome (SIRS) and generations. Compensatory anti-inflammatory response syndrome (CARS) is the main line and actively intervenes to increase the success rate.