Steveling H, Stamatis G, Costabel U
Pneumologie Universitätsklinik, Ruhrlandklinik Essen, Tuschener Weg 40, 45239 Essen, Germany.
Internist (Berl). 2007 Jun;48(6):597-605. doi: 10.1007/s00108-007-1866-1.
The physician involved in internal medicine and general practice is confronted with a series of challenges in patients with pulmonary resection. In the early post-operative phase, optimal analgesia and physiotherapy are the primary factors for achieving the best possible function after loss of pulmonary tissue and for the determination of complications. Post thoracotomy syndrome requires interdisciplinary therapy. In the later course, it is necessary to take into consideration effects on pulmonary circulation, on the musculoskeletal system and on the digestive tract as well as sleep disturbances due to diaphragm dysfunction. Corresponding symptoms should be considered and actively sought, for example using echocardiography for assessment of cor pulmonale or outpatient sleep monitoring for detection of sleep-disordered breathing. Thus, aftercare includes much more than the search for a relapse or formation of metastases in cases of the most common cause of pulmonary resection, bronchial cancer.
从事内科和全科医疗的医生在肺切除患者中面临一系列挑战。在术后早期，最佳的镇痛和物理治疗是肺组织切除后实现最佳功能以及确定并发症的主要因素。开胸术后综合征需要多学科治疗。在后期病程中，有必要考虑对肺循环、肌肉骨骼系统和消化道的影响，以及因膈肌功能障碍导致的睡眠障碍。应考虑并积极寻找相应症状，例如使用超声心动图评估肺心病，或通过门诊睡眠监测检测睡眠呼吸紊乱。因此，随访护理所涵盖的内容远不止在肺切除最常见病因（支气管癌）病例中寻找复发或转移灶。
