Lung cancer patients in the surgical treatment of

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Lung cancer patients in the surgical treatment of moderate to severe COPD

Look strong, surgery is relatively easy cases, the full measure and full preparation after elective surgery. Feasibility of such patients was suggested that the limitations of non-radical surgery, postoperative radiotherapy and chemotherapy combined with ~. Lung cancer with c () I'I) than a simple c () II) indications for surgery is strict and complicated. We usually select the I ~ Ⅱ A type of peripheral lung cancer and not associated with coronary heart disease, diabetes, liver and kidney dysfunction, and malnutrition. After preoperative treatment improved lung function and pulmonary function test basis. Further line of oxygen before and after the detection of arterial blood gases, oxygen at rest before the Ia ():> 60mmHg, PaC02 90; suck pure oxygen after 10min Pa ()!> 200mmHg. PaCO! 95. Surgery could be considered seriously inadequate or over-confidence often a security risk. 2.2 The traditional surgical method of early postoperative thoracotomy can cause reduced lung function 3O ~ j0. Poor respiratory reserve that lung cancer patients in a severe c () II) were very bad. Guaranty based on the quality of operation. Should try to choose a small incision. Or assisted thoracic small incision. To reduce respiratory muscle damage, avoid excessive traction rib vertebral joint damage. This not only significantly reduce the postoperative pain. Xiongshihuxi help the recovery and sputum. And can shorten the operation time. Adhesion to the chest wall has to be fully separated. Resection of lung tissue to facilitate retention of space shift. If suspected lymph node metastases. Used under conditions of small incision assisted thoracoscopic removal, may be required to achieve tumor cure. In addition to tumor resection range 2.3 to 15 ~ 3O outside the lung tissue is appropriate. In order to facilitate the improvement of lung function. Lobectomy lung volume accounted for about 25 to 30, about 15 lung segments, while in lung resection of lung volume reduction surgery cum. On the part of the same paragraph, unusual leaves or bullae of lung cancer patients with pulmonary wedge excision is required in selected parts of the lung bullae lung tissue where the volume reduction removed. Multiple bullae on a modest electrocautery to the surface of pleural thickening and contracture of variability in order to achieve volume reduction purposes and to prevent the bullae rupture 2.4 Perioperative This study shows that, after 2 weeks to 3 months of surgery before medical treatment. Can significantly improve lung function. Create the conditions for the thoracic surgery. Respiratory muscle injury and surgery, endotracheal intubation, surgical stimulation, suction human narcotic drugs (cholinergic agents) the role and C () PI) the existence of other factors. Can cause postoperative respiratory weakness, respiratory sputum and sticky. Increased ventilatory defect. The sharp decline in lung function. So. Perioperative airway protection is the most important surgical safety measures. In addition to conventional antibiotics, antispasmodic, expectorant, oxygen and other treatment, physical therapy with the breath. Including relaxation, assisted expectoration, respiratory training, respiratory muscle training, psychological support. Can effectively alleviate the airway spasm promote secretion discharge. Increase the ventilation flow. In order to protect gas exchange. Suction surgery should be strictly controlled narcotic drugs and human use of muscle relaxants. Anesthesia and operation time as short as possible. Early postoperative intensive care, if necessary, auxiliary suction line bronchoscopy or tracheostomy. Fatigue and other causes of respiratory hypoxia and (or) CO! Accumulation in patients with severe mechanical ventilation should be given. 2.5 mechanical ventilation on lung cancer with postoperative dyspnea in patients with COPD. Mechanical ventilation to correct hypoxia and can be quickly discharged c ()!, Can usually be PsV, SIMV ten PS or PEEP ventilation, etc.. In recent years, we use the BiPAP ventilator support. Also play a significant role to correct hypoxia, compared with the conventional ventilator was no different. However, for the non-invasive BiPAP ventilation, and spontaneous respiration can be carried out simultaneously. Avoid the phenomenon of human confrontation. Reduce barotrauma and the use of sedatives, the patient feels more comfortable. . At the same time because of all auxiliary Yang Lumin. Such as lung cancer with l {1 degree 【'() II) the process y-surgical treatment to help maintain a single mode of ventilation. To avoid the operation of the conventional ventilator misjudgment. Reduce the workload of health care. So. We advocate on awake and breathing on his own good should be preferred in patients with severe hypoxic BiIAP assisted ventilation in general. With improved surgical techniques and methods. Perioperative care and management levels. And the c () PD-depth knowledge and so on. Of lung cancer with moderate to severe (, () II) in patients with selective thoracic surgery has achieved initial results. Many questions still need to continue education efforts and analyzed. 【
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