肺局灶性磨玻璃影(GGO)病变的诊疗体会

Experience in the treatment and diagnosis of pulmonary focal ground-glass opacity (GGO)

目的:探讨肺局灶性GGO的最佳治疗方式。方法:回顾性分析2007年1月至2013年12月我院收治的CT影像表现为肺局灶性GGO病变105例。对肺局灶性GGO的CT影像、手术的时机选择、手术方法、病理分型等数据进行分析。结果:接受手术治疗69例,其中局部肺切除21例,肺叶切除48例,15例发现淋巴结转移,其中混合型GGO 14例,单纯型GGO 1例。手术病例中恶性病变占74%(51/69)。36例未手术病例中,21例持续抗炎治疗至病变吸收、消散,最长3例治疗6周。6例未经继续抗炎或手术治疗,CT随诊后病灶消失。6例病灶无变化继续随诊,3例病灶增大患者拒绝手术探查。手术病例随诊6个月至5年,无复发或转移。结论:单纯型GGO可行局部肺切除或肺叶切除,同时加淋巴结探查,混合型GGO需行肺叶切除加淋巴结清扫。

Objective：To study the best treatment of pulmonary focal GGO. Methods：To analyze the CT images, operation time, surgical treatment and pathological of 105 cases of pulmonary focal GGO from January 2007 to Decem- ber 2013. Results： Sixty nine cases accepted surgical treatment, 21 cases accepted partial pneumonectomy, and 48 ca- ses accepted pneumonectomy among them. Among 15 cases with lymph node metastasis, 14 cases were mix GGO and 1 case was pure GGO. Malignant lesions were 74% 69 cases（ 51/69 ）. Among 36 cases with no surgical treatment,21 cases were cured by anti - inflammatory therapy, there were 3 cases lasting six weeks. 6 cases with no treatment. 6 ca- ses with no change. 3 cases became lager but they refused surgical treatment. Those cases recepted surgical treatment follow -up from six months to five years with no recurrence and transfer. Conclusion：Pure GGO can be cured by par- tial pneumonectomy or pneumonectomy with lymph node detection, mix GGO should be treated by pneumonectomy with lymph node cleaning.