同期外科手术治疗肺癌合并重度冠心病的安全性和有效性  

Safety and efficiency of simultaneous surgical treatment of lung cancer and severe coronary artery disease

作　　者：李芝 魏磊 王晓伟 周景昕 戚晓通 李京杭 黄浩彬 张憬 LI Zhi;WEI Lei;WANG Xiaowei(Department of Cardiovascular Surgery,First Affiliated Hospital,Nanjing Medical University,Nanjing 210029,CHINA)

机构地区：[1]南京医科大学第一附属医院心脏大血管外科

出　　处：《江苏医药》2019年第11期1148-1151,共4页Jiangsu Medical Journal

摘　　要：目的总结同期外科手术治疗肺癌合并重度冠心病患者的安全性和有效性。方法20例肺癌合并重度冠心病患者同期行肺癌根治术和非体外循环冠状动脉旁路移植术(A组),通过倾向性评分匹配法筛选出20例行单纯肺癌根治术的肺癌合并重度冠心病患者(B组),比较两组手术相关指标。结果两组患者年龄相仿[(70.6±7.6)岁vs.(68.4±5.4)岁](P>0.05)。与B组比较,A组手术时间延长[(346.4±78.6)min vs.(171.6±62.6)min]、术中出血量和术后胸腔总引流量增多(中位数:450 ml vs.90 ml和2375 ml vs.800 ml)(P<0.01)。两组术后住院时间比较无统计学差异[(19.7±13.0)d vs.(14.1±5.0)d](P>0.05)。两组3年生存率、无复发生存率和总生存率比较亦无统计学差异(P>0.05)。结论同期外科手术治疗肺癌合并重度冠心病患者安全、有效。Objective To summarize the safety and efficiency of simultaneous surgical treatment of the patients with lung cancer and severe coronary artery disease.Methods Twenty patients with lung cancer and severe coronary artery disease underwent simultaneous lung resection and off-pump coronary bypass grafting(group A).A simple radical resection of lung cancer was performed in another 20 matched cases(by a method of propensity score matching)(group B).The surgery-related indicators were compared between the two groups.Results There was no significant difference in age between the two groups[(70.6±7.6)years old vs.(68.4±5.4)years old](P>0.05).Compared to group B,group A had a longer operation time[(346.4±78.6)minutes vs.(171.6±62.6)minutes],more intraoperative bleeding and total thoracic drainage(median 450 ml vs.90 ml and 2375 ml vs.800 ml)(P<0.01).There was no significant difference in postoperative hospital stay between the two groups[(19.7±13.0)days vs.(14.1±5.0)days](P>0.05).There were no significant differences in 3-year survival rate,recurrence-free survival rate and total survival rate between the two groups(P>0.05).Conclusion For the patients with lung cancer and severe coronary artery disease,simultaneous performance of the lung resection and off-pump coronary bypass grafting is safe and effective.

关 键 词：肺癌 冠心病 心肺转流 非体外循环冠状动脉旁路移植术 

分 类 号：R654[医药卫生—外科学]