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[目的]总结非小细胞肺癌全肺切除术术后心肺并发症及其临床规律,指导肺癌全肺切除术心肺并发症的防治。[方法]回顾性分析本单位1999年1月～2006年12月施行全肺切除手术的74例非小细胞肺癌患者的临床资料,观察指标包括严重心律失常、肺部感染、ARDS、低血容量性循环障碍等常见心肺并发症和血流动力学变化及预测的肺功能。[结果]全组闱术期死亡1例(1.4%),16例(22%)出现心肺并发症。心肺并发症包括严重心律失常10例、急性呼吸窘迫综合症(ARDS)3例、肺部感染2例及低血容量性循环障碍8例。[结论]非小细胞肺癌全肺切除术后心肺并发症常见,其原因主要是血流动力学及肺功能改变;术前准确的心肺功能评估,术后密切的监护,及时、正确的处理是防治全肺切除术心肺并发症的关键。
[Objective] To summarize the postoperative cardiopulmonary complications and its clinical rules after pneumonectomy for non-small cell lung cancer and to guide the prevention and treatment of cardiopulmonary complications of pneumonectomy. [Methods] The clinical data of 74 patients with non-small cell lung cancer undergoing total pneumonectomy from January 1999 to December 2006 were retrospectively analyzed. The observed indicators included severe arrhythmia, pulmonary infection, ARDS, hypovolemia Common circulatory disturbances and other common cardiovascular complications and hemodynamic changes and predict the lung function. [Results] One patient (1.4%) died during operation and 16 patients (22%) had cardiopulmonary complications. Cardiopulmonary complications included 10 cases of severe arrhythmia, 3 cases of acute respiratory distress syndrome (ARDS), 2 cases of pulmonary infection and 8 cases of hypovolemic circulatory disorders. [Conclusion] Cardiopulmonary complications after pneumonectomy are common in non-small cell lung cancer. The reasons are mainly hemodynamics and pulmonary function changes. Correct preoperative cardiopulmonary function assessment, close monitoring after surgery, timely and correct treatment are Prevention of pneumonectomy cardiopulmonary complications of the key.