肺癌袖式切除术42例临床分析(1)
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[摘要] 目的：探讨肺癌袖式切除术的手术效果及其对肺癌患者的临床意义。方法：选取本科2005年1月～2010年6月收治的82例肺癌患者，随机分为两组，42例治疗组患者采取肺癌袖式切除术， 40例对照组患者采取患侧全肺切除术，比较两组患者手术效果，包括手术死亡率、术后并发症发生率及患者5年内存活率。结果：本组病例1例患者于术后6 d发生支气管胸膜瘘，继发肺部感染，治疗无效死亡。余41例患者术后未出现肺不张、脓胸及肺动脉栓塞等术后并发症，术后1周均作支气管镜复查，患者支气管未发现吻合口狭窄现象，术后5～8 d拔除胸管，多数患者有排痰不畅，给予吸痰处理，术后12～28 d，41例患者均康复出院，平均住院时间为17 d。术后5年内随访本组其余41例患者，18例患者死亡。结论：肺癌袖式切除术手术创伤小、手术死亡率及术后并发症发生率低，患者5年内存活率高，该术式最大限度地保留了肺癌患者的健康肺组织，提高了患者晚期生活质量。
[关键词] 肺癌；袖式切除术；支气管成形术；肺动脉成形术
[中图分类号] R655.3 [文献标识码]B[文章编号]1674-4721(2011)06(b)-116-02
Sleeve resection of lung cancer clinical analysis of 42 cases
NIE Zhengbo ,ZHAO Anlai,GUO Yueming
Department of Cardiothoracic Surgery, Central Hospital of Yiyang City ,Hunan Province, Yiyang 413000, China
[Abstract] Objective: To investigate lung cancer sleeve resection of the effect of surgery and the clinical significance of patients with lung cancer. Methods: 82 patients in our department from January 2005 to June 2010 of lung cancer patients were treated randomly divided into two groups, 42 cases of lung cancer patients treated with sleeve resection to 40 cases of control group patients to take ipsilateral pneumonectomy surgery, surgical results two groups were compared, including operative mortality, postoperative complications and survival rate of patients within 5 years. Results: 1 patient in this group of patients 6 days after surgery occurred in the bronchial fistula, secondary pulmonary infection, treatment, died. After more than 41 patients without pulmonary atelectasis, empyema, and postoperative complications such as pulmonary embolism, 1 week after bronchoscopy were reviewed for patients of bronchial anastomotic stricture was found phenomenon, 5-8 days after removal of chest tube, most patients have poor expectoration, given suction treatment, after 12-28 days, 41 patients were discharged, the average hospital stay of 17 days. After 5 years follow-up of more than 41 patients in this group, 18 patients died. Conclusion: The lung cancer sleeve resection surgical trauma, operative mortality and postoperative complication rate, high survival rate of patients within 5 years, the maximum retained surgical patients with lung cancer and healthy lung tissue and improve the lives of patients with advanced quality.
[Key words] Lung cancer; Sleeve resection; Bronchoplasty; Pulmonary artery angioplasty
肺癌在国内乃至全世界都是最常见的癌症死因之一，近30年来该病发病率呈明显上升趋势 ......
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