左肺全切术后ECMO辅助下食管癌根治术

发布时间：2018-10-24 14:29

【摘要】：本文对一例左肺全切术后发现食管癌并在体外膜肺氧合技术(ECMO)的支持下成功接受根治性手术治疗的患者进行病例分析。患者,男性,74岁,因“左肺全切术后12年余,进食哽噎感1月余”入院。患者左肺术后恢复良好,定期复查未见肺癌复发或转移。外院胃镜病理证实为食管鳞癌。入院后体格检查及其余术前检查未见明显肿瘤远处转移,最后在ECMO技术的辅助下行右进胸食管癌根治术(Ivor-Lewis incision)。患者术后顺利脱机,2天后由监护室转回普通病房,术后第14天出院。左肺全切术后行食管癌根治术的临床病例报道较为罕见,主要是因为在手术过程中,由于考虑手术视野,不能进行常规右侧气管插管通气,导致手术技术要求高、操作难度大,并且如何在围手术期保证患者有良好的氧合也是对手术辅助技术的考验。由于目前临床上对ECMO应用较少,本文希望通过这个病例报告,来提高对ECMO应用范围的认识并推广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.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R655.3;R735.1

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