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目的探讨食管癌切除术中单肺通气时间对患者术后肺部并发症和呼吸功能的影响。方法食管癌切除术患者65例,所有患者术中均持续单肺通气,按单肺通气时间长短分为A组(<2小时)、B组(2~3小时)和C组(>3小时),分别记录术中单肺通气时间、术前(T1)、术后30分钟(T2)及术后24小时(T3)PaO_2和PaCO_2值、术后肺部并发症发生例数、并发呼吸衰竭例数及术后总住院时间,分析并比较不同单肺通气时间对3组患者血气指标、术后肺部并发症及术后住院时间的影响。结果 A组患者PaO_2值在T3时间点为(92.77±14.97)mmHg,C组为(79.97±9.91)mmHg,两组比较,差异有统计学意义P<0.05);3组间PaO_2值在T1、T2时间点、PaCO_2值在T1、T2、T3时间点间比较,差异均无统计学意义(P>0.05);B组术后肺炎发生率为61.3%(19/31),C组术后肺炎发生率为68.8%(11/16),均显著高于A组(22.2%,4/18,P均<0.01,C组术后肺不张发生率为43.8%(7/16),A组为5.6%(1/18),两组比较,差异有统计学意义(P<0.05);C组术后平均住院时间(12.88±1.67)天,A组(10.83±1.30)天,两组比较,差异有统计学意义(P<0.01)。3组患者术后并发呼吸衰竭例数比较,差异无统计学意义(P>0.05)。结论食管癌患者术中长时间单肺通气可增加术后肺部并发症的发生率,延长术后住院时间。
Objective To investigate the effect of single lung ventilation on postoperative pulmonary complications and respiratory function during esophageal cancer resection. Methods Sixty-five patients underwent esophageal resection and all patients underwent continuous one-lung ventilation during operation. Patients were divided into group A (<2 hours), group B (2 to 3 hours) and group C (> 3 hours) ) Were recorded intraoperative pulmonary ventilation time, preoperative (T1), 30 minutes after surgery (T2) and 24 hours after surgery (PaO2 and PaCO2 T3 values, the number of cases of postoperative pulmonary complications, complicated by respiratory failure The number of cases and the total postoperative hospital stay were analyzed and compared. The effects of different durations of single lung ventilation on the blood gas indexes, postoperative pulmonary complications and postoperative hospital stay were analyzed. Results The values of PaO_2 in group A were (92.77 ± 14.97) mmHg at T3 and 79.97 ± 9.91 mmHg in group C, the difference was statistically significant (P <0.05) There was no significant difference in the value of PaCO_2 between the time points of T1, T2 and T3 at T2 (P> 0.05). The incidence of postoperative pneumonia in group B was 61.3% (19/31) (P <0.01). The incidence of atelectasis in group C was 43.8% (7/16) after operation, and the incidence of atelectasis in group A was significantly higher than that in group A (22.2%, 4/18, (P <0.05). The average postoperative hospital stay (12.88 ± 1.67) days in group C and (10.83 ± 1.30) days in group A were significantly lower than those in control group (5.6%, 1/18) , The difference was statistically significant (P <0.01) .3 cases of patients with respiratory failure complicated by complications, the difference was not statistically significant (P> 0.05) .Conclusion Long-term intraoperative pulmonary ventilation in patients with esophageal cancer can increase postoperative The incidence of pulmonary complications, prolonged postoperative hospital stay.