手术治疗突入主支气管腔的中心型肺癌(附9例报告)  

Treatment of central lung cancer broke into the main bronchus or trachea by surgery(Reports of 9 cases)

作　　者：韩波[1] 张书文[1] 石文君[2] 

机构地区：[1]内蒙古包钢医院,内蒙古包头014010 [2]中国医科大学附属盛京医院

出　　处：《山东医药》2013年第3期70-72,共3页Shandong Medical Journal

摘　　要：目的总结突入主支气管腔的中心型肺癌的手术治疗经验。方法 9例突入主支气管腔的中心型肺癌患者,术中均在病变所在肺叶支气管或左右主支气管根部5 mm处环支气管一周切开支气管(暂命名为环支气管肺切除术);左全肺切除2例,右全肺切除1例,左肺上、下叶切除各1例,右肺中下叶切除1例,右肺上叶切除3例。结果本组无手术死亡。所有患者术后复查胸部CT片见余肺膨胀良好,经纤维支气管镜或胸部CT气管支气管三维重建检查见支气管通畅、无狭窄;术后1例发生喉返神经可逆性损伤,于术后3周完全恢复。经长期随访,1例于术后3周发生脑梗死而死亡,1例于术后半年发生意外事件死亡,1例于术后5 a失访;余6例中存活1 a 1例,4 a 1例,5 a 2例,6 a 1例,8 a 1例。结论对突入主支气管腔的中心型肺癌可行环支气管肺叶切除术或环支气管全肺切除术,既能完整地切除肺肿瘤又能最大限度地保留健康的肺组织,疗效满意。Objective To summarize the experience of the surgery for intracavitary central lung cancer which broke into the main bronchus. Methods A total of 9 patients with central lung cancer underwent around-bronchus lobectomy and pneumonoresection, retain 5 mm lobe bronchus or main bronchus. Left pneumonectomy was performed in 2 patients, fight pneumonectomy in 1 patient, left upper lung lobectomy in 1 patient, left lower lung lobectomy in 1 patient, fight mid-lower lung lobectomy in 1 patient, fight upper lung lobectomy in 3 patients. Results There was no operative mortality. All the patients＇ CT-chest showed the remaining lung expanded well, fiberoptic bronchoscopy or CT three-dimensional reconstruction showed trache and bronchi was smooth without stenosis. Postoperative recurrent laryngeal nerver was reversibly dam- aged in 1 patient who recovered within 3 months. Long-term follow-up showed that 1 patient died from cerebral infarction after 3 weeks, 1 died from accident after six months, 1 patient lost to follow-up after 5 years, the others： 1 survived for 1 year, 1 for 4 years, 2 for 5 years, 1 for 6 years, 1 for 8 years. Conclusion Around-bronchus pneumonoresection and lo- bectomy in the treatment of the central lung cancer broke into the main bronchus or trachea is capable of excising complete lung cancer while remaining healthy lung tissue as much as possible.

关 键 词：中心型肺癌 全肺切除 环支气管肺切除 

分 类 号：R655.3[医药卫生—外科学]