外科治疗中央型肺癌的疗效分析.docVIP

外科手术治疗非小细胞中央型肺癌的疗效分析 曹丕健，洪志鹏 　 昆明医科大学第一附属医院，云南 昆明 650032 ［摘要］背景与目的：非小细胞中央型肺癌是肺肿瘤的最常见类型，行肿瘤根治性切除手术依然是目前治疗肺癌的最有效途径，本文探讨袖状切除治疗非小细胞中央型肺癌的临床经验及疗效。方法：回顾性分析昆明医科大学第一附属医院胸外科2008年7月—2014年1月行手术治疗的207例非小细胞中央型肺癌患者的临床及随访资料。结果：全组207例患者中，195例行根治性切除(R0切除)，R0切除率为94.2%。单侧全肺切除127例，该组获R0切除率93.7%；80例行袖状切除（单袖切除66例，双袖切除14例），该组获R0切除率95%，两组比较R0切除率差异无统计学意义(P＞0.05)。术后主要并发症包括心率失常、肺部感染、肺不张、呼吸衰竭，支气管胸膜瘘、死亡。全肺切除患者术后1例因呼吸衰竭死亡，发生心率失常8例、肺部感染6例、肺不张0例、呼吸衰竭5例、支气管胸膜瘘2例；袖状切除患者发生心率失常1例、肺部感染2例、肺不张1例、呼吸衰竭0例、死亡0例、支气管胸膜瘘0例。两组比较获袖状切除患者术后并发症少于全肺切除患者有统计学意义（P0.01)。单侧全肺切除128例获得随访114例，术后1、3、5年累积生存率分别为63.15%，35.96%，17.54%，袖状切除80例获得随访80例，术后1、3、5年累积生存率分别为88.75%，48.75%，35%。获袖状切除患者术后生存率优于全肺切除患者，差异有统计学意义(P0.01)。结论：袖状切除术可减少术后患者并发症提高术后生活质量及存活率，可达到同全肺切除同样的手术根治效果,是目前治疗非小细胞中央型肺癌的理想手术方式。 　　［关键词］　肺肿瘤；肺切除；疗效 中图分类号：R734.2　　文献标志码：B　 Clinical efficacy of sleeve lobectomy for central type lung cancer CAO Pi jian,HONG Zhi peng (the First Affiliated Hospital of Kunming Medical University, Kunming Yunnan 650032, China) Correspondence to: HONG Zhi peng E-mail:hzp doc@ ［Abstract］ Background and purpose: Non-small cell central type lung cancer is the most common type of lung tumor, underwent radical resection of tumor surgery remains the treatment of lung cancer is the most effective way, this study explores the sleeve shape excision in the treatment of non-small cell central type lung cancer experience and curative effect.Methods: retrospective analysis of the first affiliated hospital of kunming medical university in July 2008 - January 2014 thoracic surgery surgical treatment of 207 cases of patients with non-small cell central type lung cancer clinical and follow-up data.Results: the whole set of 207 patients, 195 underwent radical resection (R0 resection), R0 resection rate was 94.2%.Unilateral 127 cases of pneumonectomy, the group received R0 resection rate 93.7%;80 regular sleeve shape excision (single sleeve resection in 66 cases, double sleeve resection, 14 cases), the group won the R0 resection rate 95%, two groups