肺血管阻断和成形技术在肺叶切除术中的应用

Application of pulmonary vessel occlusion and angioplasty in lobectomy

目的探讨肺血管阻断和成形技术在肺叶切除术中的临床应用效果。方法回顾性分析2007年1月至2012年12月38例在我院行肺血管阻断和(或)成形肺叶切除术患者的临床资料,分析肺血管阻断和成形技术的应用情况。结果 38例患者中合并右上支气管袖式切除术2例,左上支气管袖式切除术2例。均应用肺动脉阻断和(或)成形技术,其中12例行肺动脉直接修补成形术,4例行肺动脉袖状切除术。本组无死亡病例,无大出血、支气管胸膜瘘、肺动脉狭窄和出血及肺动脉血栓等并发症发生。8例患者术后发生肺部感染或胸腔积液,3例发生心律失常,全部经保守治疗治愈。全部患者肺血管阻断时间6～28 min,平均(11.4±7.1)min,术中失血量为110～390 ml,平均(168±55)ml。结论肺叶切除术中合理应用肺血管阻断和成形技术,出血量少,并发症少,安全性好,对肺叶切除术的成功起至关重要的作用。

Objective To investigate the clinical effect of pulmonary vessel occlusion and angioplasty in lo- bectomy. Methods The clinical data of 38 patients undergoing lobectomy with pulmonary vessel occlusion and an- gioplasty from Jan. 2007 to Dec. 2012 in our hospital were retrospectively analyzed. The application of pulmonary ves- sel occlusion and angioplasty was investigated. Results Among the 38 patients, 2 were combined with upper right bronchus sleeve resection, and 2 was combined with left bronchial sleeve resection. All patients underwent pulmonary vessel occlusion and angioplasty, of which 12 were treated with simultaneously direct repair of pulmonary angioplasty, 4 with anastomosis angioplasty. No deaths were found, with no complications as haemorrhage, bronchopleural fistula, pul- monary stenosis, pulmonary artery thrombosis, and bleeding. Eight patients were found with postoperative chest infection or pleural effusion, and 3 were found with arrhythmia, which were all cured by conservative treatment. The pulmonary vascular occlusion time was 6-28 min, with a mean of （11.4± 7.1） min. The intraoperative blood loss was 110-390 ml, with an average of（168±55） ml. Conclusion Application of pulmonary vessel occlusion and angioplasty in lobecto- my results in less blood loss, fewer complications, good safety, which plays a vital role for the success oflobectomy.