双侧胸腔病变的围手术期处理  

Perioperative management of bilateral thoracic diseases

作　　者：邹卫[1] 许栋生[1] 杨如松[1] 马国栋[1] 潘宴青[1] 刘政呈[1] 王科平[1] 曹磊[1] 刘锋[1] 曹珲[1] 赵一昕[1] 

机构地区：[1]南京市胸科医院胸外科,210029

出　　处：《江苏医药》2011年第15期1800-1806,共7页Jiangsu Medical Journal

摘　　要：目的探讨双侧胸腔病变时需行普胸外科手术病例的临床特点及围手术期处理对策。方法对7例双侧胸腔及肺不同病变(A组)和84例相同病变(B组)的病例资料进行回顾性分析。结果 A组中,一侧肺叶切除3例,纵隔肿瘤切除2例,分期两侧肺叶切除2例。B组中,肺大疱合并或不合并气胸51例,其中的30例接受了电视胸腔镜手术。B组其余33例为双侧原发性或转移性肺癌6例、肺结核16例、支气管扩张症8例和支气管源性肺囊肿3例;其中的28例仅做一侧手术。两组均无围手术期死亡。结论双侧胸腔内存在不同种及同种病变临床并非少见,不同种病变中最常见的是各种类型结核合并其他疾病,同种病变最常见的是双侧肺大疱(合并或不合并气胸)。双侧病变并非均需手术处理,而是根据具体病情定夺。Objective To investigate the clinical features and perioperative management of surgical patients with bilateral thoracic diseases.Methods Data of of 7 cases with different diseases on two sides（group A） and 84 cases with same bilateral thoracic diseases treated with surgical operation（group B） were retrospectively analyzed.Results Seven cases in group A were diagnosed with different bilateral thoracic diseases,of whom 3 cases were treated with unilateral lobectomy,2 cases with resection of mediastinal tumor and 2 cases with staged bilateral lobectomy.There were 51 cases of pulmonary bullae with or without pneumothorax in group B,of whom 30 cases underwent video assistant thoracic surgery.The rest 33 cases of group B included 6 cases with bilateral primary or metastatic lung cancer,16 cases with pulmonary tuberculosis,8 cases with bronchiectasis and 3 cases with pulmonary bronchogenic cysts,of whom 28 cases underwent unilateral thoracic surgery.There was no perioperational death in both groups.Conclusion Same or different bilateral thoracic diseases are not rare.Tuberculosis with other diseases was the most common in different bilateral thoracic diseases,while bilateral pulmonary bullae with or without pneumothorax is the most common in same bilateral thoracic diseases.Not all of cases with bilateral thoracic diseases require bilateral surgeries and it depends on patients′ pathogenetic conditions to plan the treatment.

关 键 词：双侧胸腔病变 

分 类 号：R655[医药卫生—外科学]