肺癌外科治疗技术的改进

Improvement of surgical treatment technique on lung carcinoma:report of 1 178 cases

目的 为在肺癌的外科治疗过程中减少并发症的发生率 ,提高手术治疗效果。方法 对前期 (1972年 2月至 1989年 2月 )与后期 (1989年 3月至 1999年 2月 )的 1178例肺癌病例在麻醉方法、手术入路、肺根及癌灶的处理、手术并发症的发生率和死亡率等方面进行了分析比较。结果 手术时间由平均 2 17min减少至 12 9min ;术中输血量由平均 830ml减少至 46 0ml;呼吸衰竭发生率由 3 4%降至 1 5 % ;急性心肌梗塞发生率由 4 6 %减少至 1 3% ;支气管胸膜瘘由 1 6 %降至 0 9% ;手术死亡率由 2 3 %降至 0 3%。结论 由于麻醉技术、手术方法和围术期处理等方面的改进 ,后期病例的手术治疗效果明显优于前期病例。

Objective To decrease the incidence of complication and improve the effects of operative treatment during the surgical treatment on lung carcinoma.Methods 1 178 lung carcinoma cases,which include earlier stage (from Feb.1972 to Feb.1989) and later stage (from Mar.1989 to Feb.1999),were analyzed and compared on methods of anesthesia,incision of operation,treatment on root of lung and carcinomatous foci,incidence and mortality of operative complication,and so on.Results The average duration of operation was reduced from 217 minutes to 129 minutes.The average quantity of blood transfusion during operations was reduced from 830ml to 460ml.The incidence of respiratory failure was reduced from 3.4% to 1.5%.The incidence of acute myocardial infarction was reduced from 4.6% to 1.3%.The incidence of bronchopleural fistula was reduced from 1.6% to 0.9%.The mortality of operations was reduced from 2.3% to 0.3%.Conclusion With the improvements on anesthesia methods,operative technique and perioperative management,the operative effect of the cases of later stage is obviously better than the ones of earlier stage.