肺癌解剖性肺段切除和肺楔形切除术后肺功能评估临床研究.docVIP

肺癌解剖性肺段切除和肺楔形切除术后肺功能评估临床研究 　　摘要：目的 比较肺癌解剖性肺段切除与肺楔形切除术后肺功能的变化。方法 2011年1月～2014年1月在我院行肺癌解剖性肺段切除与肺楔形切除术各50例，用标准的全胸腔镜肺叶切除术切口，根据解剖随后用高2.5mm白钉治疗节段性肺动脉和静脉，高3.5mm蓝色钉治疗支气管，及系统性淋巴结清扫。结果 100例均顺利完成肺癌解剖性肺段切除与肺楔形切除术。手术时间115 ～ 260min，平均182min；术中出血量100～300ml，平均230ml。胸腔引流时间2～6d，平均3.5d。术后住院3～11d，平均7.5d。术后肺功能无差异。结论 肺癌解剖性肺段切除与肺楔形切除术治疗肺癌和肺功能无差异，是安全可行的选择。 　　关键词：肺楔形切除术；肺段切除术；肺癌；肺功能 　　Abstract：Objective To investigate the feasibility of video-assisted thoracoscopic lung resection， safety and operation indications. Methods From 2011 January to 2014 January in our hospital underwent thoracoscopic anatomic lung resection in 100 cases， using standard completely thoracoscopic lobectomy incision， according to anatomic followed by high 2.5mm white nail nail bin treatment of segmental pulmonary arteries， segmental vein， with high 3.5mm blue nail nail bin treatment bronchial， and systematic lymph node dissection. Results 12 cases were successfully completed thoracoscopic anatomic resection pulmonary segment resection. Operation time was 115 ～ 260min， average 182min； the intraoperative blood loss was 100 ～ 300ml， average 230ml. Chest drainage time 2 ～ 6D， average 3.5d. Postoperative hospital stay was 3 ～ 11d， average 7.5d. No two operation， no blood， no peri operation period death. The postoperative pathology： 6 cases of adenocarcinoma， 2 cases of squamous cell carcinoma， wherein the primary non small cell lung cancer were classified as stage a. 12 cases were followed up for 1 ～ 24 months， average 9 months， 10 cases had no recurrence， metastasis of lung cancer. Conclusion Thoracoscopic anatomic segmentectomy with other comorbidities for non small cell lung cancer and pulmonary function in stage Ⅰ a difference or not suitable for lobectomy， is a safe and feasible option. 　　Key words：Wedge resection of lung； Lung resection； Lung cancer； Pulmonary function 　　我国肺癌患者日益增多，肺癌解剖性肺段切除与肺楔形切除术可以更多的保留正常肺组织，有利于肺癌患者术后肺功能的恢复和生活质量的改善[1]。我科2011年1月～2014年1月施行肺癌解剖性肺段切除与肺楔形切除术，现报道如下。 　　1 资料与方法 　　1.1一般资料 本组肺癌患者100