全胸腔镜下肺叶切除术34例临床剖析.docVIP

全胸腔镜下肺叶切除术34例临床剖析 　　[摘要] 目的 探讨全胸腔镜下肺叶切除术治疗肺部疾病的临床体会及临床应用价值。 方法 2015年10月～2017年6月，我院共为34例肺部疾病患者行全胸腔镜下肺叶切除术，并对26例恶性肿瘤患者实施肺门及纵膈淋巴结清扫术。其中行左肺上叶切除11例，左肺下叶切除6例，右肺上叶切除8例，右肺中叶切除2例，右肺下叶切除7例，术后常规放置一根胸腔引流管。 结果 全组患者手术顺利，无围手术期死亡，无中转开胸，无严重并发症发生。平均手术时间（142.8±11.2）min，术中出血量（77.4±26.7）mL，术后胸腔引流管放置时间（5.4±1.3）d，清扫淋巴结数目（15.4±3.1）枚，术后住院时间（8.7±2.6）d。随访3～16个月，1例Ⅱb期腺癌患者在术后7个月发生转移，其余患者无复发及转移。 结论 全胸腔镜下肺叶切除术治疗肺部疾病具有创伤小、痛苦少、恢复快等优点，具有重要的临床应用价值。 　　[关键词] 全胸腔镜；肺叶切除术；肺部疾病；价值 　　[中图分类号] R655 [文献标识码] B [文章编号] 1673-9701（2018）05-0051-03 　　[Abstract] Objective To discuss clinical experience and application value of pulmonary disease treated by video-assisted thoracoscopic pulmonary lobectomy. Methods Since October 2015 to June 2017， 34 patients with pulmonary disease were treated with video-assisted thoracoscopic pulmonary lobectomy in our hospital， and 26 malignant tumor patients were given hilar and mediastinal lymph node dissection. There were 11 cases of left lung superior lobectomy， 6 cases of left lung inferior lobectomy， 8 cases of right lung superior lobectomy， 2 cases of right lung middle lobectomy， and 7 cases of right lung inferior lobectomy. A intrathoracic tube was placed after operation in routine process. Results Operations were successful in all patients， and there were no perioperative deaths， transfer thoracotomy or serious complications. The mean operation time was（142.8±11.2） min， and the operative blood loss amount was（77.4±26.7） mL. The postoperative intrathoracic tube placement time was（5.4±1.3）d， and lymph node dissection number was（15.4±3.1）， and postoperative hospitalization time was（8.7±2.6） d. The patients were followed up for 3-16 months. Metastasis occurred in 1 case of adenocarcinoma in phrase Ⅱb， and no palindromia and metastasis in other patients. Conclusion Video-assisted thoracoscopic pulmonary lobectomy in treatment of pulmonary disease has the advantages of less trauma， less pain and faster recovery， which has important clinical application value. 　　[Key words] Vi