胸腔镜肺叶切除术的临床效果观察(附374例报告)  

Clinical results of video-assisted thoracoscopic lobectomy: a report of 374 cases

作　　者：杨博[1] 戴为民[1] 初向阳[1] 孙玉鹗[1] 王钰琦[1] 汪涛[1] 刘阳[1] 赵明[1] 

机构地区：[1]解放军总医院胸外科,北京100853

出　　处：《解放军医学杂志》2013年第5期387-390,共4页Medical Journal of Chinese People's Liberation Army

摘　　要：目的探讨胸腔镜下肺叶切除术的安全性及可行性。方法回顾性分析2007年5月-2012年5月在解放军总医院胸外科行胸腔镜下肺叶切除术的374例患者的临床资料。结果 374例患者包括恶性肿瘤304例,良性病变47例,不典型腺瘤样增生18例,出血1例,另有4例患者胸部CT表现为磨玻璃样小结节,术后病理未能检出病变。手术方式包括右肺上叶切除81例,右肺中叶切除40例,右肺下叶切除73例,左肺上叶切除64例,左肺下叶切除89例,复合肺叶切除27例。手术时间158.4±33.5min,术中出血量136.3±55.3ml,19例患者接受输血。术后47例患者出现并发症,3例患者死亡。术后拔管时间4.3±1.9d,术后住院时间7.5±2.9d。结论胸腔镜肺叶切除术是一种安全、有效的手术方式,适用于多种肺部疾病的外科治疗。Objective To investigate the feasibility and safety of video-assisted thoracoscopic lobectomy. Methods Clinic data of 374 patients who had undergone video-assisted thoracoscopic lobectomy from May 2007 to May 2012 in the General Hospital of PLA were retrospectively analyzed. Results Among the 374 patients, the pathological diagnosis included 304 of malignant tumor, 47 of benign lesion, 18 of atypical adenomatous hyperplasia, 1 of pulmonary hemorrhage, and 4 with ground-glass opacity appearance in chest CT images but no pathological change was found after operation. The surgical procedure included right upper lobectomy in 81 cases, right middle lobectomy in 40, right lower lobectomy in 73, left upper lobectomy in 64, left lower lobectomy in 89, and compound lobectomy in 27. The average operation time was 158.4± 33.Stain, intraoperative blood loss was 136.3 ± 55.3ml, and 19 patients received blood transfusion during the operation. After the operation, 47 patients suffered complications and 3 patients died. The average postoperative extubation time was 4.3±1.9d, and the average postoperative hospital stay was 7.5 ± 2.9d. Conclusion Video-assisted thoracoscopic lobectomy is a safe and reliable surgical procedure and may be applied to different pulmonary diseases.

关 键 词：胸外科手术 电视辅助 肺叶切除术 治疗结果 

分 类 号：R655.3[医药卫生—外科学]