Tandon S, Batchelor A, Bullock R, Gascoigne A, Griffin M, Hayes N, Hing J, Shaw I, Warnell I, Baudouin S V
Department of Anaesthesia and Intensive Care Medicine, Newcastle upon Tyne NHS Trust, UK.
Br J Anaesth. 2001 May;86(5):633-8. doi: 10.1093/bja/86.5.633.
Acute lung injury after oesophagectomy is well recognized but the risk factors associated with its development are poorly defined. We analysed retrospectively the effect of a number of pre-, peri- and post-operative risk factors on the development of lung injury in 168 patients after elective oesophagectomy performed at a single centre. The acute respiratory distress syndrome (ARDS) developed in 14.5% of patients and acute lung injury in 23.8%. Mortality in patients developing ARDS was 50% compared with 3.5% in the remainder. Features associated with the development of ARDS included a low pre-operative body mass index, a history of cigarette smoking, the experience of the surgeon, the duration of both the operation and of one-lung ventilation, and the occurrence of a post-operative anastomotic leak. Peri-operative cardiorespiratory instability (measured by peri-operative hypoxaemia, hypotension, fluid and blood requirements and the need for inotropic support) was also associated with ARDS. Acute lung injury after elective oesophagectomy is associated with intraoperative cardiorespiratory instability.
食管癌切除术后的急性肺损伤已广为人知，但其发生的相关危险因素尚不明确。我们回顾性分析了多个术前、术中和术后危险因素对在单一中心接受择期食管癌切除术的168例患者发生肺损伤的影响。14.5%的患者发生了急性呼吸窘迫综合征（ARDS），23.8%的患者发生了急性肺损伤。发生ARDS的患者死亡率为50%，其余患者为3.5%。与ARDS发生相关的特征包括术前低体重指数、吸烟史、外科医生的经验、手术及单肺通气的持续时间，以及术后吻合口漏的发生。围手术期心肺不稳定（通过围手术期低氧血症、低血压、液体和血液需求量以及对血管活性药物支持的需求来衡量）也与ARDS相关。择期食管癌切除术后的急性肺损伤与术中心肺不稳定有关。
