肺癌和支气管肿瘤行全肺切除术的临床治疗

Clinical therapy on tumors of lung and bronchus by pneumonectomy

目的:全肺切除术(Pneumonectomy)是治疗中心性肺癌、毁损肺等疾病的手术。适应于肿瘤已累及肺叶支气管开口或肿瘤起源于一侧主支气管的病例,前提是肺功能良好。本组对26位临床实施全肺切除术的患者的探讨,分析全肺切除术的临床使用价值及有关的问题。方法:术前对患者进行常规检查后,进行全肺切除。术后采用影像学检查和TNM分期。结果:术后患者痊愈率为93.2%,术后严重并发症发生率为11.5%。结论:全肺切除术占肺切除术5%～10%;右全肺切除应该尽量避免。尤其是70岁以上高龄肺癌患者,行全肺切除术有较大的风险,要根据肺功能状态和病变范围并结合血气分析、心脏功能等因素综合分析合理选择适应证和术式并重视围手术期管理。需要强调的是:不论任何方式的肺切除手术,术中都要常规清扫肺门、隆突下淋巴结和纵隔淋巴结。在病理科医生的配合下获得准确的病理分期,从而指导术后的辅助治疗方案。

Objective Resection of lung（Pneumonectomy） is the treatment of central lung cancer,damage to lung diseases such as surgery.Adapted to the tumor has been involved lobe bronchus opening or the side of the main bronchus tumor originated in the case,the premise is good lung function.The group of 26 clinical implementation of whole lung resection of patients,analysis of whole lung resection using the value and related issues.Methods Routine preoperative examination of patients,were pneumonectomy.Imaging examination after operation,and TNM stage.Results Cure rate was 93.2% of patients after surgery,postoperative complications rate was 11.5%.Conclusion Resection of lung accounted for 5% of lung resection to 10%;the right pneumonectomy should be avoided.Especially in lung cancer patients over the age of 70,with total lung resection have a greater risk,according to the lung function status and extent of disease combined with blood gas analysis,comprehensive analysis of cardiac function and other factors and surgical indications of reasonable choice and the importance of perioperative Of management.Needs to be emphasized is this：regardless of any form of lung resection surgery,patients have regular cleaning in the hilar,subcarinal lymph nodes and mediastinal lymph nodes.In cooperation with the pathologist to obtain accurate staging to guide adjuvant treatment.