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目的:探讨老年重症、高危食管癌根治患者的围手术期处理.方法:总结1989年6月～1997年5月手术治疗612例食管癌中老年重症高危患者56例,分析治疗过程及并发症的处理.结果:强化围术期心功能保护和呼吸道管理,取得了满意的治疗效果,全组治愈.结论:应强调加强围术期管理,特别是扩冠治疗改善心肌缺血,增加心功能储备;在呼吸道管理中,可以采取环甲膜穿刺注药刺激咳嗽排痰,气管镜吸痰并支气管灌洗,合理使用呼吸机及积极抗感染治疗,为成功扩大手术适应症,安全度过手术关创造了有利的条件.
Objective: To investigate the perioperative management of elderly patients with severe, high-risk esophageal cancer radical operation.Methods: From June 1989 to May 1997, surgical treatment of 612 cases of esophageal cancer in 56 cases of elderly patients with severe high-risk surgery, analysis of the course of treatment and complications Results: The perioperative cardioprotection and respiratory tract management were strengthened, and the satisfactory curative effect was achieved and the whole group was cured.Conclusion: Emphasis should be placed on perioperative management, especially coronary crown expansion to improve myocardial ischemia and increase cardiac function reserve ; In respiratory tract management, you can take cricothyroid injection to stimulate cough expectoration, bronchoscopy sputum suction and bronchial lavage, the rational use of ventilator and active anti-infective therapy, surgical indications for the successful expansion of safety through surgical clearance Created favorable conditions.