肺癌切除术中大出血的分析及处理

Analysis on Massive Hemorrhage During Operation of Lung Cancer

目的 :分析肺癌切除术中血管意外损伤大出血的发生与病人的年龄 ,肿瘤的部位、侵袭 ,淋巴结转移之间的关系 ,探讨大出血时的处理方法。方法 :对 30 6例中心型肺癌术中血管意外损伤大出血 13例进行回顾性分析。结果 :术中血管意外损伤的发生率与肿瘤的部位及TNM分期因子 (pT、pN)相关 (P <0 .0 5 )。结论 :当肺门淋巴结和纵隔淋巴结转移并融合时 ,左上叶肺癌行左上叶切除时损伤左肺动脉的发生率最高 ,右上、中叶肺癌行右上、上中叶切除术时损伤右肺动脉的发生率次之 ,双侧下叶肺癌行下叶切除时损伤动脉的发生率最低。笔者总结的方法能快速。

Objective:To analyze the relation of age of patient,tumor location, and invasion of lymph nodes to massive hemorrhage due to damaging blood vessel unexpectedly during operation of lung cancer and to discuss the management of the massive hemorrhage. Methods: 306 cases operated on for lung cacer, including 13 casese of massive hemorrhage during operation, were reviewed retrospectively. Results: The morbidity of damaging blood vessel during operation was correlated with tumor location and TNM classification (pT,pN)(P<0.05). Conclusion: When there are metastasis and fusion of hilar and mediastinal lymph nodes, the occurrence rate of damaging left lung artery during cutting left lobe of lung is very high. However, the occurrence rate of damaging right lung artery during cutting right upper and middle lobes of lung is lower; the occurrence rate of damaging lung artery during cutting left and right lower lobes of lung is the lowest. The handling ways of massive hemorrhage concluded in this article could control the hemorrhage rapidly and validly.