外科治疗在低肺功值肺癌病人中的作用  

Effect of Surgical Treatment in Lung Cancer Patients of Severe Depression of Respiratory Function.

作　　者：罗南[1] 李琼[1] 赵夏[1] 周克海[1] 刘红兵[1] 黄云[1] 邹强[1] 

机构地区：[1]四川省自贡市第四人民医院、泸州医学院附属自贡医院胸心外科,643000

出　　处：《中华临床医学杂志》2006年第1期33-35,共3页Chinese Journal of Clinical Practical Medicine

摘　　要：目的 探讨外科治疗在肺功能差的肺癌病人中的可行性。方法 1995年1月-2003年12月，对46例用常规肺功能测定为低肺功值（MVV％≤45％，FVE1％≤45％）的病人加用闭气试验，爬二楼后血氧饱和度测定对心肺功能进行综合评价，并在给予呼吸综合训练后，分成手术治疗（22例）与对症治疗（24例）两组进行治疗。手术组中：全肺切除1例，两叶切除1例，一叶切除（包括袖式切除和隆突重建）13例，楔形切除7例。结果 手术组围术期死亡1例。对症组住院死亡4例，并发症中手术组和对症组分别为：咳痰困难15例和18例，呼吸困难11例和15例，气管切开9例和6例，心律紊乱11例和10例，血糖高12例和6例。1年成活77．3％和66．7％，2年成活54．5％和33.3％。结论 结合实际做好术前心肺功能综合评价和呼吸训练，灵活选择手术术式，缩短麻醉、手术时间，加强围术期管理，对低肺功值的肺癌病人采用手术治疗是可行和有意义的。function. Methods Objective To evaluate effect of the surgical treatment in lung cancer patients of severe depression of respiratory From January, 1995 to Deeember,2003,The 46 lung cancer patients that with standard respiratory function judged is MVV% ≤ 45% and FVEI % ≤ 45 % added stop breathing test and exercise blood oxygen saturation determine test evaluated cardiopulmonary function again, but trained respire way. Then divided to two group treatment： surgical treatment group （22） and support treatment group （24）. In surgical treatment, There was pneumonectomy 1 case, two Iobectomy I case, one Iobectomy（ include sleeve resection and carinal reconstruction） 13 case,wedge resection 7 case. Results surgical death 1 case, support death 4 case. Surgical and support respective complication were cough up phlegm difficult 15 and 18, dyspneic respiration 11 and 15, traeheostomy 9 and 6, cardiac arrhythmias 11 and 10, diabetes 12 and 6. survival rate 77.3%and 66.7% in one year, 54.5% and 33.3% in two yeaes. Conclusion Done well clinical cardiopulmonary function evaluated and trained respire way before operation, selected operative way Accurately, shorten time of anaesthesia and operation, to strength postoperation management, it is helpful to lung cancer patients of severe depression of respiratory function with surgical treatment,

关 键 词：低肺功值 肺癌病人 外科治疗 

分 类 号：R781[医药卫生—口腔医学]