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目的探讨老年人开胸手术期的处理。方法总结46例70～84岁老年人围手术期的临床经验。结果术后并发心律失常31例，心功能不全7例，腔隙脑梗塞1例，肾功能不全1例，肝功能不全1例，均有不同程度的ALI，其中9例符合ARDS，应用容许性高碳酸血症机械通气治疗而愈。结论老年人开胸手术并存症、并发症高，术前必须最大限度的改善患者的全身情况，对麻醉、手术及术后处理均提出较高要求，尤以心肺并发症为术后防治重点，容许性高碳酸血症机械通气治疗在一定程度上改善了ARDS患者的预后。
Objective To investigate the treatment of thoracic surgery in elderly patients. Methods The clinical experience of 46 patients aged 70-84 years during the perioperative period was summarized. Results There were 31 cases of postoperative arrhythmia, 7 cases of cardiac insufficiency, 1 case of lacunar infarction, 1 case of renal insufficiency, and 1 case of hepatic insufficiency. All of them had different degrees of ALI, and 9 of them met ARDS. Hypercapnia is the result of mechanical ventilation. Conclusion The complications and complications of thoracic surgery for the elderly are high. Before the operation, the general condition of the patient must be improved to the maximum extent. High requirements are required for anesthesia, surgery and postoperative management. Cardiopulmonary complications are the key for prevention and treatment. Permissive hypercapnia mechanical ventilation has improved the prognosis of patients with ARDS to some extent.