52例气管支气管及肺血管成形术治疗中心型非小细胞肺癌的经验

Trachea-bronchial and Pulmonary Arterial Sleeve Resection and Reconstruction in the Treatment of Central NSCLC

摘要目的:研究气管支气管及肺血管成形术的适应证、术中处理及并发症的防治。方法:分析本院1989年7月～l999年8月,52例接受气管支气管及肺血管成形术肺癌患者的临床资料。结果:本组并发症发生率为21.2%(11/52),主要为肺不张和肺部感染。术后30天内死亡率5.8%(3/52)。术后1、3、5年生存率分别为89.8%(44/49)、56.7%(17/30)及33.3%(7/21)。结论:气管支气管及肺血管成形术治疗中心型非小细胞肺癌,不仅能最大限度地保留肺组织,提高患者术后生存质量,且为部分肺功能差的患者提供了切除病变的机会。随着麻醉技术和外科技术的提高,术后并发症减少,术后30天内死亡率降低,值得临床推广应用。

Objective:To study admission and management of trachea-bronchial and pul-monary artery and prevention of complications with trachea -bronchial and pulmonary arterial sleeve resection and reconstruction in the treatment of central non -small cell lung cancer(NSCLC).Methods:52cases of central NSCLC treated with this procedure in our hospital from l989to l999were analyzed.ResuIts:The incidence of complications was21.2%(11/52).Main of them were atelectasis and pulmonary infection.The mortality in30days post-operation was5.8%(3/52).The overall1,3and5-year survival rate was89.8%(44/49),56.7%(17/30)and33.3%(7/21)respective1y.Conclusion:The results suggest that trachea-bronchial and pulmonary arterial sleeve resection and reconstruction in the treatment of patients with central NSCLC can not only maximize preservation of functional pulmonary parenchyma and improve patients life quality,but also provide an opportunity to the patients with low pulmonary function to resect the tumor.This procedure may be spread out clinically for its lower mortality and less complications with the im-provement of the anesthetic technology and surgical management .