胸腔镜肺叶切除在Ⅰ/Ⅱa期非小细胞肺癌治疗中的临床应用  

Clinical application of thoracoscopic lobectomy in the treatment of stage Ⅰ/Ⅱa non-small cell lung cancer

作　　者：霍云奎[1] 张雍偲[1] 闫晓亮[1] 闫秀文[1] 刘福[2] 

机构地区：[1]山西医科大学第一医院心胸外科,山西太原030001 [2]山西医科大学,山西太原030001

出　　处：《临床医学研究与实践》2017年第20期116-117,共2页Clinical Research and Practice

摘　　要：目的深入分析和探讨胸腔镜肺叶切除在Ⅰ/Ⅱa期非小细胞肺癌治疗中的临床应用效果。方法收集我院2009年1月至2014年1月收治的104例Ⅰ/Ⅱa期非小细胞肺癌患者,然后对这一部分患者全部进行胸腔镜肺叶切除,同时进行系统性淋巴结清扫,分析胸腔镜肺叶切除在Ⅰ/Ⅱa期非小细胞肺癌治疗中的临床应用效果。结果这104例患者术中中转开胸5例(2例胸腔广泛粘连,1例淋巴结与肺动脉舌支门钉样粘连,2例损伤左上肺动脉尖支),术中出血100~600 mL,术后无严重并发症,长期漏气(>4 d)7例,术后发热15例,上肺切除术后胸顶残腔3例,术后TNM分期,N2有19例,左上肺4L(+)14例,右上肺3a(+)12例,4R(+)10例,左下肺9L(+)15例,左下肺7组(+)16例,右下肺7组(+)18例。结论胸腔镜肺叶切除在Ⅰ/Ⅱ期非小细胞肺癌治疗中有良好的治疗效果,可以有效减清患者的痛苦,防止并发症的发生,促进患者的早日康复,值得进行临床推广应用。Objective To investigate the clinical application effect of thoracoscopic lobectomy in the treatment of stage Ⅰ/Ⅱa non-small cell lung cancer. Methods A total of 104 cases of patients with stage Ⅰ/Ⅱa stage non-small cell lung cancer in our hospital from January 2009 to January 2014 were selected, and underwent thoracoscopic lobectomy and systematic lymph node dissection, then the clinical effect of thoracoscopic lobectomy in the treatment of stage Ⅰ/Ⅱa non-small cell lung cancer was analyzed. Results Of the 104 patients, 5 cases were converted to thoracotomy（2 cases of pleural adhesions,1 cases of lymph node and pulmonary artery branch of tongue like nails adhesion, 2 cases of injury of the left pulmonary artery and apical branch）, intraoperative bleeding was 100-600 mL, there were no severe complications after the operation,7 cases of prolonged air leak（more than 4 d）, 15 cases of postoperative fever, 3 cases of thoracic stump cavity after upper lung resection. Postoperative TNM staging： 19 cases of N2, 14 cases of left upper lung 4L（＋）, 12 cases of right upper lung 3a（＋）,one case of 4R（＋）, 15 case of left lower lung 9L（＋）, 16 cases of left lower lung 7 group（＋）, 18 cases of right lower lung 7 group（＋）. Conclusion Thoracoscopic lobectomy has good therapeutic effect in treatment of stage Ⅰ/Ⅱa non-small cell lung cancer, can effectively mitigate the suffering of patients, and prevent complications and promote early rehabilitation of patients, which is worthy of clinical application.

关 键 词：胸腔镜肺叶切除 Ⅰ/Ⅱa期非小细胞肺癌 临床应用 效果分析 

分 类 号：R734.2[医药卫生—肿瘤]