新辅助治疗对ⅢA期非小细胞肺癌围手术期影响的研究

Study of the effect of neoadjuyant therapy to the peri-operative period of stageⅢA NACLC

目的 探讨新辅助治疗对ⅢA期非小细胞肺癌围手术期的影响。方法 1999年1月～2002年3月 ,对20例ⅢA期非小细胞肺癌患者行术前放化疗诱导治疗。选取同期行单纯手术治疗的20例ⅢA期非小细胞肺癌患者作为对照。所有病例均行根治性肺叶切除 ,以住院时间 ,胸腔闭式引流管拔除时间 ,手术出血量 ,输血量 ,术后需药物控制的心律失常 ,纤支镜吸痰次数等为指标 ,对2组进行比较。结果 诱导组在手术出血量 ,输血量及住院时间与对照组相比差异具有显著性 (P<0.05) ,而在胸腔闭式引流管拔除时间 ,术后需药物控制的心律失常 ,纤支镜吸痰次数等方面无差异 (P<0.05)。两组均无围手术期死亡 ,无支气管胸膜瘘等严重并发症的发生。结论 新辅助治疗对ⅢA期非小细胞肺癌围手术期并发症的影响是可以接受的。但代价较高。

Objective To discuss the effect of neoadjuvant therapy to the peri-operative period of stageⅢA NSCLC. Methods FromJan1999to Mar2002,20patients with stageⅢA NSCLC undergoing lobectomy after neoadjuvant therapy were compared to another20patients only treated with operation. Results There were significant differences in bleeding volume during operation and length of stay between the two groups(P<0.05).However,there were no differences in pulling out close drainage of thoracic cavity and cardiac rhythm that needed drug control and times of sputum with fiber optic bronchoscope between them.None of both groups died during peri-operative period and no serious complications such as bronchopleural fisˉtula. Conclusion neoadjuvant therapy increased the difficulty of operation,the effect was acceptable.