支气管肺动脉成形重建术治疗中央型肺癌  

Bronchoplasty and pulmonary artery reconstruction in the treatment of central type lung cancer

作　　者：陈晓峰[1] 高文[1] 丁嘉安[1] 王海峰[1] 童稳圃[1] 王律[1] 

机构地区：[1]上海市肺科医院胸外科,200433

出　　处：《中国肺癌杂志》2002年第6期411-413,共3页Chinese Journal of Lung Cancer

摘　　要：目的　探讨支气管肺动脉成形术治疗中央型肺癌的疗效。方法　自 1996年 1月至 2 0 0 0年 5月 ,采用支气管肺动脉成形治疗中央型肺癌 78例 ,其中左侧支气管肺动脉成形重建术 5 3例 ,右侧支气管肺动脉成形重建术 2 5例。术后进行了放化疗综合治疗 ,并随访了 2 4～ 78月。结果　术后 1例死于肺部感染、呼吸衰竭 ,死亡率为 1.3 %。全组术后 1、3和 5年生存率分别为 81.5 %、47.6%和 3 3 .2 %。结论　应用支气管肺动脉成形术治疗中央型肺癌是安全的。本术式扩大了手术适应证 ,特别是对于肺功能较差、高龄患者能适合地手术 ,减少了全肺切除术的比率 ,改善了患者术后生活质量 ,在临床上有应用价值。Objective To investigate the effectiveness and the surgical experience of bronchoplasty and pulmonary artery reconstruction in the treatment of central type lung cancer. Methods From January, 1996 to May, 2000, 78 patients with central type lung cancer underwent bronchoplasty and pulmoanry artery reconstruction in the treatment of central type lung cancer. According to P TNM classification, 5 patients were in stage ⅡB, 69 in stage ⅢA and 4 in stage ⅢB. The surgical procedures included bronchoplasty and pulmonary artery reconstruction in the left lung in 53 cases, bronchoplasty and pulmonary artery reconstruction in the right lung in 25 cases. A combination of comprehensive therapy including radiotherapy and chemotherapy was carried out postoperatively. The postoperative follow up ranged from 24 months to 78 months. Results There was one postoperative death resulting from respiratory infection and failure (1.3%, 1/78). The postoperative complication included pulmonary infection (6.4%) and atelectasis (7.7%). The overall 1, 3 and 5 year survival rates were 81.5%, 47.6% and 33.2% respectively. Conclusion The results suggest that bronchoplasty and pulmonary artery reconstruction for the patients with central type lung cancer is a safe and effective surgical technique, as alternative to pneumonectomy. This method ensures more radical resection of central type lung cancer, and extends the surgery indications to patients with poor lung function and senility by reducing the ratio of pneumonectomy and improving postoperative quality of life. Therefore, it is clinically valuable.

关 键 词：支气管肺动脉成形重建术 中央型肺癌 肺肿瘤 肺切除术 支气管成形术 肺动脉成形术 

分 类 号：R734.2[医药卫生—肿瘤]