胸骨正中切口治疗双侧肺疾病21例

Median sternotomy incision for 21 cases with bilateral lung diseases

目的 探讨胸骨正中切口治疗双侧肺疾病的手术方法和疗效。方法 1996年至 1999年共 2 1例双侧肺病变的病人在我院行胸骨正中切口的手术治疗 ,其中双侧肺大疱 12例 ,双侧支气管扩张症 3例 ,肺癌对侧肺内转移 1例 ,对侧纵隔淋巴结转移 2例 ,慢性阻塞性肺气肿 3例。行肺大疱结扎、肺修补术 12例 ,双肺下叶切除术 3例 ,左肺下叶切除、右肺上叶楔行切除术 1例 ,左肺下叶切除、双侧纵隔转移淋巴结清除术 2例 ,双侧肺减容术 3例。结果 胸骨正中切口开胸平均出血量 2 0 7ml,少于横断胸骨双侧开胸的平均出血量 ,手术入路简便 ,可较好地完成双侧肺疾病的手术治疗 ,病人术后效果佳。结论 胸骨正中切口是一次性手术治疗双侧肺疾病的理想、简便的切口。

Objective To review the experiences of median sternotomy incision for bilateral lung diseases.Methods The operations of lung repair, ligation of bullae, pulmonary lobectomy and resection of metastas lymph nodes, lung volume reduction surgery were taken via median sternotomy incision in 21 patients including 12 cases of bullae of bilateral lung, 3 cases of bronchiectasis, 3 cases of pulmonary carcinoma (one case of the other lung metastas, two cases of lymph node metastas in the opposite mediastinum ), 3 cases of chronic obstructive pulmonary emphysema. Results The average volume of blood loss of median sternotomy incision was 207ml,which is less than that of the clamshell incision, the oprations for bilateral lung diseases can be practised via the median sternotomy incision. The health of postoprative patients was good. Conclusion The median sternotomy incision should be a convenient and effective approch for bilateral lung diseases surgery.