106例肺切除术分析

Analyses of 106 cases of pneumonectomy

1982年3月～1994年12月，我们为各类肺部疾病进行肺切除术106例。术中、术后发生并发症23例次占21．6％，术后30日内死亡2例占1．8％．文内着重对支气管胸膜瘘、血胸、肺血管损伤大出血、癌栓脱入对侧肺支气管、肺静脉癌栓脱入股动脉及心跳聚停等并发症的防治及紧急处理进行了讨论。此外，作者认为，肺叶切除术目前在大多数病例仍是肺癌外科的“标准术式”，但在心肺功能允许并由于技术或肿瘤学原因非行全肺切除术才能达到根治性切除时，就要果断地行全肺切除，心包外处理肺血管有困难时，要毫不迟疑地采取心包内途径。

106 cases of punemonetomy were done in the patients ill with various pneumonosis from March 1982 to December 1994. Among them intraoperative or postoperative complications occurred in 23 cases (21.6% ),and two patients (1.8%) died within 30 days after the operation. The paper mainly discusses how to prevent,treat and emergently manase such complications as bronchopleual fistula,hemothorax,massive hemorrhage caused by pulmonary vessels injury,cancer embolus dropping into the heterolateral bronchus,cancer embolus in the pulmonary vein droppins into the femoral artery and cardiac arrest. Furthermore, the authors consider that up to now lobectomy is still'the standard method',but when the total pneumonectomy can be the radical resection because of some reasons on technique or oncology,it should be done resolutely. If extrapericardial management of pulmonary vessels is difficult,intrapericardial ways should be used without any hesitation.