Postoperative pulmonary complications in esophageal cancer and cardiac diagnosis
Postoperative pulmonary complications in esophageal cancer and cardiac diagnosis and treatment of postoperative pulmonary complications are the most common complications. Foreign reports 16.2% – 18%, 5.8% reported in China – 12%, representing the first postoperative complications.
Esophageal and gastric cardia postoperative pulmonary complications in the diagnosis and treatment of pulmonary complications reasons. Patients with esophageal cancer and cardiac patients, mostly older, mostly due to many patients suffering from long habit of smoking different degrees of chronic bronchitis or emphysema. Intraoperative exposure of the surgical field, long time to do the lung compression and traction, especially in upper and middle esophageal cancer, esophageal manipulation in the free subject to certain hilar and tracheal injury. After transplantation because of the stomach into the chest, causing atelectasis, postoperative incision pain, the patient did not cough, expectoration powerful. Because of these factors remain full of mucus in the trachea, with anesthesia and tracheal intubation drugs stimulate the damage to the tracheal mucosa, easily lead to bronchitis, bronchial pneumonia, atelectasis and other pulmonary complications. These pulmonary complications after surgery 24 – 72h occurred. Dilute the thick mucus, leaving over different parts of the trachea, can cause one or several complications exist. The clinical manifestations of pulmonary complications, mostly respiratory problems, faster pulse, varying degrees of hypoxia, purple knot, patient irritability, sweating, body temperature increased up to 39 C or more, a lot of sputum, lungs filled with moist eyes sound, x-ray chest perspective often seen within the inflammatory lung field sheet shadow. In atelectasis, the patient side of the chest percussion become turbid, auscultation, decreased breath sounds, the larger the range of atelectasis, can see the trachea and mediastinal shift to the affected side, chest X-ray examination of lung atelectasis can be seen image.
Postoperative pulmonary complications in esophageal cancer and cardiac diagnosis and treatment of pulmonary complications the prevention and treatment. Patients to stop smoking before surgery, patients with bronchitis to do a long time on drug treatment. Anesthesia during surgery, patients at the end of the complete removal of tracheal secretions, the prevention of postoperative pulmonary complications has important significance. The treatment of postoperative pulmonary complications, the key is to promote the discharge of the respiratory tract travel to remain sputum. Anesthetic of sufficient suction to reduce the endotracheal sputum full stay, the patient fully awake after surgery, such as breathing, blood pressure, pulse stability, which should give the patient half-lying position, to encourage patients to make cough, sputum and deep breathing movement. This position can facilitate the discharge of pleural effusion, led the early expansion of the lung. If patients had pulmonary complications, should be in the bacterial culture and susceptibility testing with the support of targeted antibiotics. For tours severe cough and stay endotracheal sputum, should be handled according to specific circumstances. If severe cough and sputum few generalized bronchiolitis, bronchial pneumonia, aerosol inhalation may be time to give in to add a small amount of atomized liquid antibiotic, expectorant, cough seriously affected as a result of pain, expectoration, should be given the right amount of sedation drugs, such as pethidine or isopropyl much, duodenal feeding tube may also be injected into the larger dose of expectorant, this treatment can often received good results. If the viscosity is not easy to cough up sputum who may be injected into the duodenal feeding tube ammonia O cable (Ambroxol), so that mucus thinning, encourage patients to cough. If by the above processing is still sputum results are poor, should intravenous ambroxol or Australia has a new (level must cough), to promote dilution of sputum, and nasal catheter suction method can be used to force the patient sputum. If the above approach is still not good sputum results, patients with severe obstructive symptoms remain missing sputum, bronchoscopy should be promptly used to save or tracheostomy suctioning patients. Severe pulmonary complications such as do not take timely and effective treatment, patients often within a few days due to respiratory and circulatory failure and death. Once it is on the pulmonary complications that should take decisive and effective treatment measures to actively deal with, do not observe the delayed adverse consequences.