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[食管癌和贲门癌手术后早期呼吸功能不全的发展特点]

[Characteristics of the development of respiratory insufficiency in the early postoperative period following surgery of cancer of the esophagus and the cardia].

作者信息

Mazurina O G, Solov'ev V E, Karamian E G, Kuz'michev V A, Remez V F, Prepelitsa K S

出版信息

Anesteziol Reanimatol. 1991 Sep-Oct(5):17-22.

PMID:1767947
Abstract

Acute respiratory failure (ARF) in the earliest postoperative period after radical surgery for esophageal cancer is characterized by staged development. Its severity is determined by the degree of ventilation-perfusion disorders and the accompanying diffusion disturbances. The following factors are considered to be ARF-provoking: postaggressive circulation centralization, predominant administration of crystalloid plasma substitutes, persistence of hypoproteinemia in the earliest postoperative period, as well as extended lymph dissection involving cardiopulmonary plexus located in the area of bifurcation. The latter factor is the peculiarity of surgery caused by oncological considerations, while three former factors should be taken into account during management of patients in the intra- and postoperative periods.

摘要

食管癌根治术后早期的急性呼吸衰竭(ARF)具有阶段性发展的特点。其严重程度取决于通气-灌注障碍的程度以及伴随的弥散障碍。以下因素被认为是引发ARF的因素:侵袭后循环集中化、晶体血浆代用品的大量使用、术后早期低蛋白血症的持续存在,以及涉及位于分叉区域的心-肺丛的广泛淋巴结清扫。后一个因素是出于肿瘤学考虑导致的手术特殊性,而前三个因素在患者围手术期管理中应予以考虑。

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