老年性肺癌的外科治疗

Surgical Treatment of Lung Cancer in Old-aged Patients

目的:总结老龄肺癌患者的外科治疗经验。方法:6 9例术前肺功能程度不同的肺癌老年患者,行一侧全肺切除5例,肺叶切除30例,局限性肺切除19例(其中胸腔镜手术6例) ,肺叶切除加支气管剔除3例,支气管袖状切除3例,肺叶切除、支气管隆突半切除成形术2例,姑息性切除5例,剖胸探查2例。结果:术后发生心功能衰竭2例,发生成人呼吸窘迫综合征(ARDS)和呼吸功能衰竭各1例,术后心肺功能衰竭发生率5 .79% ,无围术期手术死亡。结论:只要术前对手术方案及其可行性进行正确评估,围术期处理恰当。

Objective:To summarize for the clinical experience of surgical treatment of lung cancer in old-aged patients. Methods:69 old-aged patients with lung cancer underwent pneumonectomy(5 cases),pulmonary lobectomy(30 cases),limited resection(19 cases,include thoracoscopic operative approach 6 cases),bronchial sleeve lobectomy(3 cases),sleeve resection of bronchus(3 cases),partial resection of carina(2 cases),palliative operation(5 cases) and exploratory thoracotomy(2 cases). Results:The operations were successfully performed with good exposure. There was no operative death in the whole group. The postoperative complications consisted of heart failure(2 cases),ARDS(1 cases) and respiratory failure(1 cases). Conclusion:Timing of reoperative valve replacement and management of postoperative complication are important factors influencing surgical outcome. It can raise the long-term survival rate and improve the quality of life of old-aged patients with lung cancer after lung operation?