肺癌开胸探查术临床分析  

Lung cancer exploratory thoracotomy clinical analysis

作　　者：綦俊[1] 张奇[1] 

机构地区：[1]重庆市肿瘤研究所胸外科,重庆400030

出　　处：《重庆医学》2014年第13期1555-1556,1559,共3页Chongqing medicine

基　　金：重庆市卫生局科研基金资助项目(2008-2-287)

摘　　要：目的：探讨肺癌开胸后不能手术切除的原因，提高手术切除率。方法回顾性分析该院2005～2012年28例开胸后不能切除肺癌患者的临床资料，着重对术中情况与术前胸片、CT检查进行对比分析。结果该院2005～2012年的开胸探查率约为4．8％（28/583）；手术无法切除原因为：胸腔内多发转移；肿瘤、转移淋巴结侵犯肺门组织或纵隔内大血管；因肺功能受限不能耐受扩大切除术及全肺切除术。结论术前准确临床分期有助于减少开胸探查率，胸部 CT结合 X线片检查对判断肿瘤胸腔转移、肿瘤与纵隔结构的关系及决定是否手术有重要指导意义，胸腔镜及PET-CT扫描能有效减少开胸探查率。Objective To investigate the reason of inoperableness after explore thoracic cavity and improve resection rate.Meth-ods Retrospective analysed 28 cases clinical data of lung cancer patients which were inoperable after explore thoracic cavity since 2005 to 2012.Contrastive analysed intraoperative condition with X-ray photographs and CT examination on chest preoperative em-phatically.Investigate the reason of inoperableness after explore thoracic cavity and countermeasure.Results The rate of explorato-ry thoracotomy was 4.8%（28/583）since 2005 to 2012.The reason of inoperableness was multiple metastasize in thoracic cavity;tumor or metastatic lymph nodes encroach on hilum of lung or great vessels in mediastinum;unable to endure expand ectomy or to-tal pneumonectomy for pulmonary function limiting.Conclusion Exact divide clinical stage befor operating could conduce to de-crease the rate of exploratory thoracotomy.The X-ray photographs and CT examination on chest is important to j udge the neoplasm metastasis in thoracic cavity and the relationship between tumor and mediastinum and decide whether or not to operate.Thoraco-scope and PET-CT examination could decrease the rate of exploratory thoracotomy effectively.

关 键 词：肺肿瘤 开胸探查术 回顾性研究 

分 类 号：R734.2[医药卫生—肿瘤]