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目的 探讨肺癌术后呼吸衰竭的原因、预防及治疗。方法 对我院1990年1月至1997年10月肺癌术后发生呼吸衰竭的26例患者均进行了机械通气治疗,19例行气管切开术。结果 术后呼吸衰竭发生率4.7%(26/558),死亡率23.1%(6/26)。结论 呼吸道感染、手术创伤、伤口疼痛刺激、术前心肺功能异常等是引起术后呼吸衰竭的主要原因。尽早诊断、及时行气管切开术并给予机械通气是抢救成功的最有效手段,加强围手术期呼吸道管理、避免手术并发症是预防术后呼吸衰竭的关键。
Objective To explore the causes, prevention and treatment of postoperative respiratory failure in lung cancer. Methods 26 patients with respiratory failure after lung cancer from January 1990 to October 1997 in our hospital were treated with mechanical ventilation, and 19 patients underwent tracheotomy. Results The postoperative respiratory failure rate was 4.7% (26/558) and the mortality rate was 23.1% (6/26). Conclusion Respiratory tract infection, surgical trauma, wound pain stimulation, and preoperative cardiac and pulmonary function abnormalities are the main causes of postoperative respiratory failure. Early diagnosis, timely tracheotomy, and mechanical ventilation are the most effective means for successful rescue. Strengthening perioperative respiratory management and avoiding complications is the key to prevent postoperative respiratory failure.