肺切除术

78 cases, among them the lobectomy and pneumonnectomy 42 cases, pulmonary bulla rection and repair (include the video-assisted thoracic surgery, VATS), the lung volume reduction 10 cases, the oesophagus surgical operation 16 cases, the mediastinal operation 2 cases, the pyothorax operations 4 cases, and the other thoracic surgical 4 cases.

78例胸外科手术，其中肺叶、全肺切除手术42例，肺大疱切除修补（包括电视胸腔镜，VATS）、肺减容手术10例，食管手术16例，纵隔手术2例，脓胸皮质剥脱术4例，其他手术4例。

objective to discuss perioperative complication and management of patient with high risk copd following esophagectomy.methods 45 patients with high risk copd underwent esophagectomy with epidural block combined with general anesthesia.perioperative treatment included smoking cessation,chest physiotherapy,prevention and control of infection of air way and appropriate bronchodilators of air way,breathing exercises,nutrition support and oxygen therapy.painkiller was instilled after surgery,early exercises,ensuring unobstruction of the air way,mechanical ventilation was applied when needed.results 3 had hypoxaemia in operation.after surgery,all patients had spo2 somewhat declined.6 had lung infection.6 were removed of bronchial secretion by bronchoscope.2 were supported by ventilator by using intubation.2 underwent tracheotomy.1 had disturbances of acid base balance and treated by using hydrochloric acid muriatic acid.all patients recovered rather smoothly and discharged from hospital.conclusion high risk copd is not the absolute contraindication of esophagectomy.active management before and after surgery ensures the safety and recovery of patients.

目的 探讨重度慢性阻塞性肺疾病简称慢阻肺病人食管切除术围手术期常见并发症及其处理。方法 45例重度慢阻肺的病人在全麻联合硬膜外阻滞下进行开胸食管切除手术，围手术期处理包括术前戒烟、胸部理疗、预防和控制呼吸道感染、解痉化痰、呼吸功能锻炼、营养支持和氧疗；术后硬膜外镇痛、早期锻炼、保持呼吸道通畅，部分病人予以呼吸支持。结果术中3例出现低氧血症。术后所有病人pao2均有不同程度的下降，6例出现肺部感染，6例行纤维支气管镜吸痰，2例通过气管插管给予呼吸机支持，2例行气管切开术，1例酸碱平衡紊乱使用盐酸精氨酸治疗。所有病人均痊愈出院。结论重度慢阻肺病人并非开胸食管切除手术的绝对禁忌证，积极的术前准备和严格的术后管理可减少和控制术后急性发作，有助于确保此类病人的围手术期安全和康复。

Radical surgical treatment such as Extrapleural pneumonectomy, applies only to a very small number of cases limited lesions.

根治性外科治疗如胸膜外肺切除术，仅适用于极少数病变局限的病例。

Pneumonectomy for non-small cell lung cancer carries an acceptable operative mortality and provides an important survival benefit.

因非小细胞肺癌而接受全肺切除术有可接受的手术死亡率并且能提供重要的生存益处。

Radical surgery with extrapleural pneumonectomy and adjuvant treatments has become the preferred option in early disease, but the benefits of such an aggressive approach have been questioned because of significant treatment-related morbidity and mortality.

因此，多学科综合治疗得以发展，联合胸膜外肺切除术和辅助治疗的根治性手术成为早期病例的首选，但该法损伤性大且疗效因与该治疗相关的发病率和死亡率明显升高而饱受质疑。

Objective To discuss the indication and op erating technique of intrapericardial pneumonectomy,the repair of pericardial d efect,prevention of cardiac herniation and the postoperative arrhythmia.

目的 探讨心包内全肺切除术的适应证，手术技术，心包缺损修补和心脏疝预防，术后心律失常的处理等问题。

Background and objective Pulmonectomy is the first priority in treatment of non-small cell lung cancer.

背景与目的肺切除术是治疗非小细胞肺癌的首选方法之一，术后并发症是影响手术疗效的重要原因。

We have performed 4 pulmonary resections with several kinds of endoscopic instrument under thoracoscope.

4例肺切除术均在胸腔镜下使用各种内窥镜手术器械完成。

There were spontaneous pneumochorax 103 cases, lung biopsy 3 cases, pulmonary wedge resection 30 cases, pulmonary lobectomy 4 cases; hydrothorax 9 cases, pleural lesion 2 cases; mediastinum lesion 17 caese, mediastinum lymph node biopsy 3 cases, repair of pulmonary I case, repair of diaphragm 1 case.

方法173例手术中包括自发性气胸103例，肺活检3例，肺楔形切除术30例，肺叶切除4例，胸腔积液9例，胸膜病变2例，纵隔占位17例，纵隔淋巴结活检3例，外伤肺修补术1例，膈肌修补1例。

A control group of patients younger than 70 (one case/two controls) was matched for sex, cardioascular disease, American Association of Anaesthetists score, respiratory function, side of pneumonectomy, induction chemotherapy and stage.

对照组为小于70岁的患者，并对他们进行性别，心血管疾病，美国麻醉医师协会评分，呼吸功能，肺切除术侧叶，化疗诱导以及分期进行配对。

Neither the killing of Mr Zarqawi nor any breakthrough on the political front will stop the insurgency and the fratricidal murders in their tracks.

在对危险的南部地区访问时，他斥责什叶派民兵领导人对中央集权的挑衅行为。

In fact,I've got him on the satellite mobile right now.

实际上 我们已接通卫星可视电话了