计划性亚肺叶切除术对肺功能的影响  

Clinical analysis of the impact of planned sub-lobectomy on pulmonary function

作　　者：毛宇[1] 郭伟[1] 黎明[1] 张文华[1] Mao Yu Guo Wei Li Ming Zhang Wenhua(Department of Thoracic Surgery, The First Hospital of Hohhot, Hohhot010030, China)

机构地区：[1]内蒙古呼和浩特市第一医院胸外科,010030

出　　处：《中华胸部外科电子杂志》2017年第2期101-106,共6页CHINESE JOURNAL OF THORACIC SURGERY：Electronic Edition

摘　　要：目的探讨计划性亚肺叶切除术对肺功能的影响。方法选择2012年1月至2016年5月期间在内蒙古呼和浩特市第一医院胸外科行手术治疗的130例肺部肿瘤患者。其中,实验组(72例)患者因合并多种慢性疾病而肺功能不能满足肺叶切除术要求,行计划性亚肺叶切除术;对照组(58例)患者常规行肺叶切除术。分别观察两组患者的手术相关指标(包括手术时间、术中出血量、术后住院时间、术后胸腔引流管时间、术后并发症发生率)和肺功能指标(包括潮气量、第一秒用力呼气容积、第一秒用力呼气量占用力肺活量百分比、每分通气量、动脉血氧饱和度、动脉血氧分压、动脉血二氧化碳分压)。术后随访6个月至3年。结果实验组患者的手术时间、胸腔引流时间、术后住院时间均短于对照组,术中出血量少于对照组,术后并发症发生率也低于对照组,差异均有统计学意义(P<0.05)。实验组与对照组患者术前肺功能指标比较,差异均无统计学意义(P>0.05);实验组患者手术前后肺功能指标比较,差异也无统计学意义(P>0.05)。但实验组患者术后2周的肺功能指标显著优于对照组,差异均有统计学意义(P<0.05)。两组患者术后随访6个月至3年,无局部复发。结论与肺叶切除术相比,计划性亚肺叶切除术能在确保局部复发率、3年无复发生存率和3年生存率相似;在保证远期效果的基础上最大限度地保留了健康的肺组织,对呼吸功能的影响降到最小,术后以肺功能为主要指标的生存质量未见明显下降,对于心肺功能差或合并其他慢性疾病的老年患者是较明智的选择。Objective T o in v e s t ig a te th e e f fe ct of plan n ed su b -lo b ec tomy o n p ulm on ary fu n ction . Methods Select 130 p a t ien ts w i th lu n g cancer who u n d e rw e n t surg ic al tre a tm e n t of th o rac ic su rg e ry f rom January 2012 to May 2016 in H o h h o t C ity , In n e r Mongolia. Amon g th em , d ue to a v a r ie ty of chronic diseases and lung function can not meet the requirements of lobectomy, the experimental group （72 c ases ） received plan n ed sub- lobe ctomy; co n tro l g ro u p （58 c a se s ） p a t ien ts received conventional lobectomy. The surgical indicators （including the time of operat ion, intraoperat ive blood los s , pos toperat ive hospi tal stay, postoperat ive thoracic drainage tube time, pos toperat ive complicat ion rate） and lung function （including tidal volume, forced expiratory volume in f i r st second, percentage of forced expiratory volume in fi rst second to forced vital capaci ty, minute vent i lat ion volume, ar ter ial oxygen saturat ion, ar ter ial par t ial pressure of oxygen, ar ter ial par t ial pressure of carbon dioxide） of the two groups were observed respectively. Fol lowed up for 6 m o n th s to 3 y e a rs . Results T h e o p e ra t io n time, thoracic drainage time and pos toperat ive hospi tal stay were shor ter in the experimental group than in the control group. The intraoperat ive blood loss was less than that of the control group. The incidence of pos toperat ive complications was also lower than that of the control group. The difference was stat is t ical ly s ignif icant （P 〈 C〇. 05） . T h e re w e re no s ig n if ic an t d ifferences in th e lu n g fu n c tio n b e tw e en th e experimental group and the control group （P〉0.05）, B u t th e lu n g fu n c tio n index of th e ex p erim en t group was s ignif icantly bet ter than that of the control group after 2 weeks （P 〈 0. 05）. T w o g ro

关 键 词：肺癌 亚肺叶切除 肺功能 生存率 

分 类 号：R734.2[医药卫生—肿瘤]