肺部肿瘤合并轻度肺心病的临床诊治研究

Diagnosis and treatment of lung cancer combined with mild pulmonary heart disease

目的:探讨肺部肿瘤合并轻度肺心病的临床诊断及治疗方法。方法:选择80例肺部肿瘤合并轻度肺心病患者,对所有患者进行多层螺旋CT灌注成像扫描,分析其临床数据。并观察同期60例正常人的右心室血流变化。将80例患者分为实验组和对照组,实验组患者行高射频(RFA)和放化疗综合治疗,对照组患者则单纯性放化疗治疗,所有患者均给予多巴酚丁胺和低分子肝素治疗,比较两组受试者3年的生存状况以及术后的并发症发生状况。结果:恶性肿瘤与良性肿瘤在局部血流量(BF)与对比剂平均通过时间(MTT)数据间无差异性(P>0.05),局部血容量(BV)与表面通透性(PS)差异有统计学意义(P<0.05)。以BV≤4ml/100g为诊断良性肿瘤的标准,诊断准确率为92.5%,误诊率为7.5%;以PS≥9ml/100g为诊断恶性肿瘤的标准,诊断正确率为90.0%,误诊率为10.0%。80例肺部肿瘤合并轻度肺心病患者肺动脉血流加速度(ACC)、最大肺动脉血流速度值(Vm)和右心室射血力(F)较正常对照组受试者差异有统计学意义(P<0.05)。实验组患者生存3年生存率高于对照组(P<0.05)。结论:CT灌注成像可提高肺部肿瘤的诊断准确率。合并轻度肺心病的患者肺动脉ACC、Vm和F值较正常人存在差异性。行RFA和放化疗综合治疗,能够显著提高患者的3年生存率,降低死亡率和复发率。

Objective：To investigate the diagnosis and treatment of lung tumor with mild pulmonary heart disease. Methods：All 80 cases of lung cancer with mild pulmonary heart disease were treated by multi -slice spiral CT perfu-sion scan.The 80 patients were divided into experimental and control groups,patients in the experimental group and high RF chemotherapy combined therapy,the control group was simple radiotherapy and chemotherapy.All patients were given dobutamine and low molecular weight heparin.Results：For malignant and benign tumors in BF and MTT data there was no difference（P 〉0.05）,BV and PS were significantly（P 〈0.05）.In BV≤4ml/100g criteria for the diagnosis of benign tumors,diagnostic accuracy was 92.5%,7.5% misdiagnosis rate.In PS≥9ml/100g criteria for the diagnosis of malignancy,diagnostic accuracy was 90.0% misdiagnosis rate was 10.0%.80 cases of lung cancer with pulmonary heart disease combined with mild pulmonary blood flow acceleration,the maximum value and the pul-monary artery blood flow velocity right ventricular ejection force subjects difference compared with the control group was statistically significant （P 〈0 .05 ）.3 -year survival of patients in the experimental group was higher （P 〈0.05）.Conclusion：CT perfusion imaging may improve diagnostic accuracy of lung cancer.Pulmonary heart disease patients with mild pulmonary blood flow acceleration,the maximum value of pulmonary blood flow velocity and right ventricular ejection force than normal there are differences.Line -height integrated RF and chemotherapy treatment, can significantly improve the 3 -year survival of patients and reduce mortality and recurrence rate.