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目的 为在肺癌的外科治疗过程中减少并发症的发生率 ,提高手术治疗效果。方法 对前期 (1972年 2月至 1989年 2月 )与后期 (1989年 3月至 1999年 2月 )的 1178例肺癌病例在麻醉方法、手术入路、肺根及癌灶的处理、手术并发症的发生率和死亡率等方面进行了分析比较。结果 手术时间由平均 2 17min减少至 12 9min ;术中输血量由平均 830ml减少至 46 0ml;呼吸衰竭发生率由 3 4%降至 1 5 % ;急性心肌梗塞发生率由 4 6 %减少至 1 3% ;支气管胸膜瘘由 1 6 %降至 0 9% ;手术死亡率由 2 3 %降至 0 3%。结论 由于麻醉技术、手术方法和围术期处理等方面的改进 ,后期病例的手术治疗效果明显优于前期病例。
Objective To reduce the incidence of complications during the surgical treatment of lung cancer and improve the surgical treatment. METHODS: Anesthesia methods, surgical approaches, treatment of lung roots and foci, and concurrent surgery were performed on 1178 lung cancer cases from the previous (February 1972 to February 1989) and later (March 1989 to February 1999). The incidence and mortality of the disease were analyzed and compared. Results The operation time decreased from an average of 2 17 minutes to 12 9 minutes. The intraoperative blood transfusion volume decreased from an average of 830 ml to 460 ml. The incidence of respiratory failure decreased from 34% to 15%. The incidence of acute myocardial infarction decreased from 46% to 1 3%; bronchopleural fistula decreased from 16% to 09%; operative mortality decreased from 23% to 3%. Conclusion Due to improvements in anesthesia techniques, surgical methods, and perioperative management, the surgical outcomes of later cases are significantly better than those of previous cases.