孤立性肺结节的微创化诊治经验  

Minimally invasive treatment mode of solitary pulmonary nodules

作　　者：郑春辉[1] 许咏冬[2,3] 章响艳 

机构地区：[1]浙江省丽水市中心医院胸外科,浙江丽水323000 [2]上海市浦东医院 [3]复旦大学附属浦东医院胸外科,上海201300

出　　处：《中国现代医生》2014年第25期125-127,共3页China Modern Doctor

基　　金：浙江省医学会临床科研基金项目(2011ZYC-B6)

摘　　要：目的：通过分析孤立性肺结节（solitary pulmonary nodules，SPN）患者的诊疗过程，总结SPN微创化诊治模式的建立。方法对健康体检或临床检查发现的68例SPN患者进行程序化微创诊治，分析诊治过程。结果68例SPN患者经CT定位肺穿刺活检证实为肺恶性肿瘤的13例（19.1%）。胸腔镜肺结节切除证实为肺恶性肿瘤的2例（2.9%）。胸腔镜肺叶切除术16例，其中淋巴结清扫15例，术中出血50~800（344.7±222.5）mL，术后住院时间8~18（11.9±2.9）d，胸腔闭式引流管留置时间3~8（4.9±1.7）d；单纯胸腔镜肺结节切除术9例，术中出血30~200（90.3±54.3）mL，术后住院时间5~19（9.1±4.2）d，胸腔闭式引流管留置时间1~16（4.3±4.6）d。结论微创化诊治相较传统诊疗方式有其优点存在，是治疗SPN的趋势。但目前尚无普遍共识，需要建立程序化的微创诊治模式。Objective To analyze the treatment process of solitary pulmonary nodules （SPN） to establish a minimally invasive treatment model of SPN. Methods A total of 68 cases of patients with SPN were taken programmatic minimally invasive treatment. The diagnostic and treatment process was analyzed. Results 68 cases of patients with SPN were taken biopsy under CT. localization. 13 cases （19.1%） were confirmed to be pulmonary malignant tumor. 2 cases of pulmonary malignant tumor （2.9%） were confirmed by thoracoscope lung nodule resection. 16 cases were taken thoracoscope lung resection and 15 cases in the 16 cases were taken mediastinal lymph nodes dissection. The intraoperative bleeding was 50-800 （344.7±222.5） mL. The postoperative hospital stay was 8-18 （11.9±2.9） d. The thoracic drainage tube indwelling time were 3-8 （4.9±1.7）d. 9 cases were taken pure thoracoscope lung nodule resection, and the intraoperative bleeding were 30-200（90.3±54.3）mL, the postoperative hospital stay were 5-19（9.1±4.2）d, the thoracic drainage tube indwelling time were 1-16 （4.3±4.6）d. Conclusion Minimally invasive treatment is the trend for the treatment of SPN compared with the traditional treatment. It is necessary to establish a procedural model of minimally invasive treatment.

关 键 词：孤立性肺结节 微创 早期肺癌 胸腔镜肺叶切除术 

分 类 号：R816.4[医药卫生—放射医学]