【摘要】：本文對(duì)一例左肺全切術(shù)后發(fā)現(xiàn)食管癌并在體外膜肺氧合技術(shù)(ECMO)的支持下成功接受根治性手術(shù)治療的患者進(jìn)行病例分析。患者,男性,74歲,因“左肺全切術(shù)后12年余,進(jìn)食哽噎感1月余”入院�；颊咦蠓涡g(shù)后恢復(fù)良好,定期復(fù)查未見(jiàn)肺癌復(fù)發(fā)或轉(zhuǎn)移。外院胃鏡病理證實(shí)為食管鱗癌。入院后體格檢查及其余術(shù)前檢查未見(jiàn)明顯腫瘤遠(yuǎn)處轉(zhuǎn)移,最后在ECMO技術(shù)的輔助下行右進(jìn)胸食管癌根治術(shù)(Ivor-Lewis incision)�；颊咝g(shù)后順利脫機(jī),2天后由監(jiān)護(hù)室轉(zhuǎn)回普通病房,術(shù)后第14天出院。左肺全切術(shù)后行食管癌根治術(shù)的臨床病例報(bào)道較為罕見(jiàn),主要是因?yàn)樵谑中g(shù)過(guò)程中,由于考慮手術(shù)視野,不能進(jìn)行常規(guī)右側(cè)氣管插管通氣,導(dǎo)致手術(shù)技術(shù)要求高、操作難度大,并且如何在圍手術(shù)期保證患者有良好的氧合也是對(duì)手術(shù)輔助技術(shù)的考驗(yàn)。由于目前臨床上對(duì)ECMO應(yīng)用較少,本文希望通過(guò)這個(gè)病例報(bào)告,來(lái)提高對(duì)ECMO應(yīng)用范圍的認(rèn)識(shí)并推廣ECMO的使用。
[Abstract]:A case study of a patient with esophageal cancer after total resection of left lung and successful radical surgery supported by extracorporeal pulmonary oxygenation (ECMO) was carried out. The patient, male, 74, was admitted to hospital after total left lung resection for more than 12 years, eating and choking for more than one month. The patient's left lung recovered well after operation, and no recurrence or metastasis of lung cancer was found after regular reexamination. Esophageal squamous cell carcinoma was confirmed by gastroscopy. After admission, physical examination and other preoperative examinations showed no obvious distant metastasis of the tumor. At last, Ivor-Lewis incision). Was performed with the aid of ECMO technique. The patient was successfully weaned 2 days later transferred from the intensive care unit to the general ward and discharged on the 14th day after operation. The clinical cases of radical resection of esophageal cancer after total resection of left lung are rare, mainly due to the fact that, in the course of operation, the conventional right side tracheal intubation can not be performed due to the consideration of the operation visual field, which leads to the high technical requirements and the difficulty of operation. And how to ensure that patients have good oxygenation during the perioperative period is also a test of surgical aids. Because of the lack of clinical application of ECMO, this paper hopes to improve the scope of application of ECMO and promote the use of ECMO through this case report.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R655.3;R735.1

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