左肺上叶癌的外科治疗.docVIP

左肺上叶癌的外科治疗 　　作者：庞作良, 吴斌, 高胜利, 阿地力?萨来 　　【关键词】 ,左肺，上叶癌，胸心外科治疗 　　摘要：目的：探讨左肺上叶癌外科治疗的经验和体会。方法：对87例左肺上叶癌患者(中央型肺癌47例，周围型肺癌40例)行手术治疗，其中左肺上叶双袖状切除39例，单袖状切除12例，左全肺切除3例，左肺上叶切除33例。结果：手术均顺利，术后生活质量均良好，无围手术期死亡，术后并发症以心律失常多见。左肺上叶双袖状切除术39例中共行气管镜吸痰9例(23.1%)，发生房颤者8例(20.5%)，高于单纯左肺上叶切除术(9.1%)和(6.1%)，但差异无统计学意义(P0.05)。结论：双袖状切除是左肺上叶中央型肺癌的主要术式，选择合适的患者，正确的手术探查是手术成功的关键。 　　Surgery treatment of left upper lobe lung cancer 　　PANG Zuoliang, WU Bin, GAO Shengli, et al 　　(Department of Thoracic Surgery, Affiliated Tumor Hospital, Xinjiang Medical University, Urumqi 830011, China) 　　Abstract：Objective： To explore the experience of surgery treatment of left upper lobe lung cancer. Methods： From Oct， 2003 to Oct， 2005， 87 patients with left upper lobe lung cancer， 47 central and 40 peripulmonary， aged 31 to 78， were undergone operation such as sleeve resection, double sleeve resection and total pneumonectomy. Results: Eightyseven cases were all successfully treated. All cases were in good quality of life and enjoyed normal entertainments and work without severe complications， cardiac arrhythmia was the most common complication. There was no sharp difference among complications occurance between double sleeve resection and left upper lobe pneumonectomy (9.1%) vs (6.1%), P0.05. Conclusions： Double sleeve resection is an effective treatment for patients with left upper lobe lung cancer， especially central one， appropriate selections of patients are guarantee for the ultimate results of surgical treatment. 　　Key words: left lung; upper lobe cancer; surgical treatment 　　肺癌的标准术式是肺叶切除加系统性纵隔淋巴结清扫，左肺上叶癌因解剖位的特殊性，尤其是中央型肺癌，以双袖状切除为主。我科2002年10月～2005年10月共完成左肺上叶癌手术87例，其中双袖状切除39例，疗效较好，现报道如下。 　　1资料和方法 　　1.1一般资料87例中男性52例，女性35列，年龄31～78岁，术前确诊左肺上叶癌61例。其中中央型肺癌47例，周围型肺癌40例。非小细胞肺癌(NSCLC)63例，小细胞肺癌(SCLC)24例， 　　1.2方法术前除2例患者拒绝化疗外，均予以2个周期化疗(NSCLC采用NP方案，SCLC采用EP方案)。术前行呼吸道准备，术前检查除外脑、肝、骨、肾上腺转移。中央型肺癌47例中行双袖状切除39例，左全肺切除3例，左肺上叶袖状切除12例。周围型肺癌40例中左肺上叶切除33例，左肺上叶袖状切除7例。 　　2结果 　　所有患者术后均顺利恢复，术