摘要:目的 探讨重度肺功能减退胸部肿瘤病人的外科治疗及围术期处理。 方法 分析总结46例重度肺功能减退胸部肿瘤病人的手术经验及围术期管理经验。 结果 术前肺功能检查均为重度肺功能减退，FEV 1 <30%～50%、MVV<30%～50%、FVC<40%～60%。全组均经手术治疗，无手术中死亡，术后并发急性呼吸衰竭8例，死亡3例，死亡率为6.5%。 结论 重视麻醉及术中操作，加强围术期管理，大部分重度肺功能减退胸部肿瘤病人是能够耐受胸部手术的。

    关键词:重度肺功能减退;胸部手术;围术期

    Perioperative management of thoracic cancer patients associated with poor pulmonary function.

    WU Huang-fu，LIN Wei-min，LI Biao.

    (Department of Thoracic Surgery of Affiliated Xinhua Hospital of Hainan Medical College，Haikou570311，Hainan，P.R.China)

    Abstract:Objective To review the experience of surgical management and perioperative treatment of the thoracic cancer pa-tients associated with poor pulmonary function. Methods 46thoracic cancer patients associated with poor pulmonary function un-dergoing intrathoracic operation were chosen for study.Their surgery pathology included lung carcinoma in30cases and esophageal and gastric cardial carcinoma in16.8cases developed acute respiratory distress syndrome(ARDS)after operation. Results 3deaths giving9mortality rate of6.5%. Conclusion Strict and careful checkup before operation could lead to correct judgement of pulmonary function on the risk of intrathoracic surgery.Early diagnosis and treatment of ARDS is most important.Cautious preopera-tive preparations ......