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中国防痨杂志 ›› 2006, Vol. 28 ›› Issue (5): 301-304.

• 论著 • 上一篇    下一篇

结核性毁损肺外科胸膜全肺切除手术后ICU治疗28例分析

康乃民1;张秀娟2;刘立群2;   

  1. 1北京市结核病胸部肿瘤研究所ICU 北京 101149;2北京市通州区新华医院内科 北京 101101;
  • 出版日期:2006-05-10 发布日期:2006-11-03

The treatment for the destroyed lung pleuropneumonectomy postoperative patients in ICU

Kang Naimin1,Zhang Xiujuan,Liu Liqun.   

  1. 1.ICU department,Beijing TB and Thoracic Tumor Research Institute,Beijing 101149,China
  • Online:2006-05-10 Published:2006-11-03

摘要: 目的提高对结核性毁损肺行全肺切除患者的围手术期ICU的治疗水平。方法对结核性毁损肺28例患者,于手术后住ICU监测治疗:动态监测生命体征、出血情况、肺功能、血气分析;治疗合并疾病;纤维支气管镜吸痰;应用呼吸机进行无创或有创机械通气,治疗急性呼吸衰竭。结果20例患者经过ICU加强诊疗,术后顺利恢复;8例患者出现急性呼吸衰竭,经过无创及有创呼吸机机械通气治疗后好转;2例合并胸腔感染、支气管残端瘘患者,其中1例死亡。结论结核性毁损肺胸膜全肺切除手术后病人的围手术期诊疗中,在动态监测病情、防治手术后应激反应、治疗手术后急性呼吸衰竭等方面ICU有明显优势。

关键词: 结核,肺/外科学, 重症监护

Abstract: Objective To improve the treatment for the destroyed lung pleuropneumonectomy postoperative patients in ICU.Methods 28 patients who suffered the destroyed lung by pulmonary tuberculosis have been selected to acceptthe surgical treatment,pleuropneumonectomy.All of themhave accepted the intensive caretreat-ment after operation including continuous monitoring patient’slife signs,the bleeding amount, the function of the lung,the blood gas analysis;treating the complicated diseases;getting rid of sputum by bronch of ibroscope; treatingthe acute respiratory failure by using ventilator.Results Through the treatment in ICU,20 patients smoothlyrecovered.8 patients complicated withthe acute respiratory failure accepted the ventilator, NPPV, or PSV+PEE Pventilation, and recovered. 2 patients complicated withinfectionandfistulae of bronchial stump,a-mong whomone patient died.Conclusions Duringthe postoperative treatment for patients who accept pleurop-neumonectomy, ICUdepartment plays animportant role in continuous monitoring and treatment, reducing stress,treating acute respiratoryfailure.

Key words: Pulmonary tuberculosis/surgery, ICU treatment