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目的探讨氩氦刀治疗晚期非小细胞肺癌合并呼吸衰竭的原因及预防措施。方法在CT引导下局麻行冷冻治疗,术中、术后监测心率、呼吸、血压、指脉氧、血气分析等变化,术后绝对卧床休息,持续吸氧。出现呼吸衰竭后行支气管镜检查,需要时给予抽痰、临时植入气管支架或高频电刀消融治疗,以畅通气道。结果术后1h~4天9例患者发生呼吸衰竭,其中8例患者有慢性阻塞性肺疾病基础,死亡1例。结论在此类患者治疗前、后进行支气管镜介入干预,能降低呼吸衰竭发生率或减轻呼吸衰竭的程度。
Objective To investigate the causes and preventive measures of argon-helium knife in the treatment of advanced non-small cell lung cancer with respiratory failure. Methods CT-guided local anesthesia was used for cryotherapy. Intraoperative and postoperative monitoring of heart rate, respiration, blood pressure, finger pulse oxygenation, blood gas analysis and other changes, absolute postoperative bed rest, sustained oxygen. After the occurrence of respiratory failure bronchoscopy, sputum as needed, temporary tracheal stent implantation or high-frequency electric knife ablation treatment to smooth the airway. Results Respiratory failure occurred in 9 patients 1 h to 4 days after operation. Among them, 8 patients had the basis of chronic obstructive pulmonary disease and 1 died. Conclusions The bronchoscopic intervention before and after such treatment can reduce the incidence of respiratory failure or reduce the degree of respiratory failure.