Objective To analyze the risk factors of post-operative respiratory failure in elderly cardiac carcinoma patients.Methods 28 elderly patients with respiratory failure (respiratory failure group) after the resection of cardiac carcinoma and 56 controls (control group) were studied.Preoperative respiratory function,the other complications,the site of incision,intravenous infusion,age of patients and smoking between two groups were compared by Logistic regression.Results Univariate risk factors included MVV<50% ,RV/TLC>50% ,FEV1<1.5L,PEF<70% ,DLCO<80% ,V75<70% ,the venous input,incision at chest.Multivariate logistic regression analysis identified that MVV<50% ,RV/TLC>50% ,FEV,<1.5 L,DLCO<80% were risk factors.Conclusion These results suggested that the patients with risk factors described above need more careful pre and post operative surveillance and management.

近年,随着老年医学的迅速发展,接受手术治疗的老年贲门癌病人不断增加,而呼吸衰竭(respiratory failure,RF)是术后较为常见、凶险的并发症之一[1].本文旨在分析可能导致老年贲门癌术后发生RF的高危因素.

目的:探讨贲门癌根治术后心律失常的诱发因素.方法:将我院1987～1998年收治的贲门癌术后发生心律失常的56例资料,与按1:2比例随机抽取同期贲门癌术后未发生心律失常的112例资料作对照,用x2检验及Logistic回归分析两组动脉血气监测结果、血清电解质变化情况、术前血液流变学、术前是否存在高血压史及心肌缺血、年龄、手术方式及术后是否应用有效镇痛等诸因素与术后心律失常发生的关系.结果:术后低氧血症、术后低钾血症、术前全血粘度增高、术前有高血压史、心肌缺血史、经胸(包括胸腹联合切口)、术后疼痛因素与心律失常发生有显著相关性.结论:为预防术后心律失常的发生,术前应重视对患者的心血管并发症治疗及改善血液流变学特性,术后要加强监测,及时纠正低氧血症、补钾,有效止痛.

目的探讨支气管成形术治疗肺癌的手术适应证、手术方法、术后并发症及其疗效.方法本文收集了30例中央型肺癌及支气管腔内癌病例,施行支气管成形术并经随访和总结.结果由于肺癌发病年龄较大,心肺功能减退,虽无手术早期死亡,然而支气管成形术并发症发生率明显高于常规原发性肺癌手术.结论支气管成形术治疗肺癌必须严格掌握手术指征,术后围手术期应用严密观察、及时处理合并症,并定期随访,提高手术疗效.

目的 分析肺错构瘤的临床特征和外科治疗。方法 收集本院胸外科手术治疗并经病理证实为肺错构瘤 75例。分析其症状、病程、影像特征、外科治疗等 ;6 9例进行了 6个月～ 2 2年的随访。结果 患者年龄大多为 30～ 6 0岁 ,30岁以下仅 6例。 48例 （6 4% ）无临床症状 ,9例有咳嗽或胸痛不适 ,6例有血痰 ,3例咯血。X线或 /和 CT显示孤立的圆形或卵圆形阴影。 0 .5 cm～ 8.8cm大小 ,＜3cm者占 76 % ,3例显示肺不张。结论 肺错构瘤多为局部发育异常 ,致使正常支气管组织在数量和排列上发生异常。它与肺癌难予鉴别 ,是不可逆转的病变 ,应采用外科手术治疗。预后一般良好