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目的 了解胸部肿瘤患者手术死亡的影响因素，探讨有效的预防措施。方法 对近４ 年间我科５８ 例手术死亡患者的临床资料进行分析。结果 胸部肿瘤患者总的手术死亡率为２ ．１ ％ ，其中食管肿瘤为３ ．３ ％ ，明显高于其他部位肿瘤（ Ｐ＜ ０ ．０１） ；６０ 岁以上患者手术死亡率为３ ．４ ％ ，明显高于６０ 岁以下患者（１ ．０ ％ ，Ｐ＜ ０ ．０１） ，并占所有手术死亡患者的７２ ．４ ％ （４２／５８） ；全肺切除、全胃切除及食管切除颈部吻合患者的手术死亡率明显高于其他相应较小的术式。结论 影响胸部肿瘤患者手术死亡的主要因素有肿瘤部位、患者年龄及手术范围。６０ 岁以上患者由于受年龄及伴随疾病的影响，占手术死亡患者的主要部分。选择合理的手术指征及术式，注意术中操作及术后监护，及时处理各种术后并发症，对减少胸部肿瘤患者的手术死亡有重要意义。
Objective To understand the influencing factors of operative death in patients with thoracic tumors and to explore effective preventive measures. Methods The clinical data of 58 patients with surgical death in our department during the past 4 years were analyzed. Results The total operative mortality in patients with thoracic tumors was 2. 1%, of which esophageal cancer was 3. 3%, significantly higher than other parts of the tumor (P <0. 01); patients over the age of 60 mortality was 3. 4%, significantly higher than those under 60 (1.0%, P <0.01), accounting for 72% of all patients who died of surgery. 4% (42/58). The operative mortality in patients undergoing total pneumonectomy, total gastrectomy and esophagectomy for neck anastomosis was significantly higher than that of other correspondingly smaller operative procedures. Conclusion The main factors influencing the operative mortality in patients with thoracic tumors are the location of the tumor, the age of the patient and the scope of the operation. Patients over the age of 60 due to age and concomitant diseases, accounting for the major part of patients died of surgery. Select appropriate surgical indications and surgical procedures, pay attention to intraoperative and postoperative care, timely treatment of various postoperative complications, reduce the surgical mortality of patients with chest cancer is important.