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目的探讨老年食管癌患者切除术后肺部并发症的原因及防治。方法回顾分析1990年至2004年91例70岁以上老年食管癌患者手术。结果共发生肺部并发症11例,其中1例死亡。结论本文资料显示,术后肺部并发症的发生机制是术后咳嗽动力学的改变。术前肺部合并症、术中损伤喉返神经、术后排痰障碍及大量输液是术后肺部并发症的诱因。提出积极治疗术前肺部合并症,加强术后呼吸道管理,控制输液量及防止术后低氧血症是防治老年食管癌患者术后肺部并发症的重要措施。
Objective To investigate the causes and prevention of pulmonary complications after resection of elderly patients with esophageal cancer. Methods The retrospective analysis of 91 cases of esophageal cancer patients older than 70 years old from 1990 to 2004 was performed. Results A total of 11 pulmonary complications occurred, including 1 death. Conclusions The data presented here show that the mechanism of postoperative pulmonary complications is the change in postoperative cough kinetics. Preoperative pulmonary complications, intraoperative recurrent laryngeal nerve injury, postoperative drainage obstruction and massive infusions are the causes of postoperative pulmonary complications. It is an important measure to prevent postoperative pulmonary complications in elderly patients with esophageal cancer by actively treating preoperative pulmonary complications, strengthening postoperative respiratory management, controlling infusion volume, and preventing postoperative hypoxemia.