三维肺支气管血管重建模拟手术在胸腔镜肺段切除治疗早期肺癌中的应用

目的:探讨三维肺支气管血管重建(3D-CTBA)模拟手术在胸腔镜肺段切除治疗早期肺癌中的效果。方法:本组共计纳入60例确诊肺癌早期患者,遵循随机数字表法分组:实验组30例、对照组30例,对照组单纯行胸腔镜肺段切除术,实验组在胸腔镜肺段切除治疗的基础上于术前实施3D-CTBA模拟手术,对比两组手术效果、术后并发症发生及随访复发情况。结果:经过相关的治疗,实验组96.67%原比对照组76.67%的总有效率高(P<0.05);实验组术后并发症发生率与随访6个月复发率分别为3.33%、0,对照组分别为20.00%、13.34%,对比差异有统计学意义(P<0.05)。结论:对早期肺癌患者,在行胸腔镜肺段切除治疗前,开展三维肺支气管血管重建模拟手术可取得满意疗效及获得良好预后。

体外循环辅助气管重建术麻醉一例

患者，男，23岁，体重45kg,因外伤性气管断裂后气管严重狭窄并支气管哮喘、呼吸衰竭，拟施行气管重建手术，术前纤维支气管镜检查提示：距声带约7.5cm气管处纤维化肉芽肿不完全阻塞致气管狭窄，狭窄处气管直径约4mm，CT提示：于胸锁关节层面以下约3mm，气管呈向心性狭窄，直径为2～3mm。

Long-term results of the hydroxylapatite for laryngotracheal framework reconstruction

Objective: To discuss the long-term results of the laryngotracheal (LT) reconstruction with a composites sternohyoid myocutaneous rotary door flap (RDF) and hydroxylapatite (HA) ring.Methods: Thirty-two patients suffered by LT stenosisn were treated through LT reconstruction with a composite sternohyoid myocutaneous RDF and HA ring, then we made long-term follow up. Results:Thirty of the 32 patients were successfully decannulated from 1 to 6 months postoperatively and the decannulation rate was 93%(30/32). Decannulated failed in 2 patients because of hypertrophic scar and infection in the operative region. The term of follow-up ranged from 1 to 10 years in 30 patients. patients had a stable airway and an effective voice. Conclusion: A composite sternohyoid myocutaneous RDF and HA ring is a relatively simple method with positive long-term effect for LT reconstruction.