晚期肺癌综合治疗中胸腔镜手术的应用价值  

The value of video-assisted thoracoscopic surgery in combined therapy for late lung cancer

作　　者：谷力加[1] 吴一龙[1] 翁毅敏[1] 冯卫能[1] 程超[1] 钟文昭[1] 黄绍洪[1] 

机构地区：[1]中山医科大学附属第三医院胸心外科

出　　处：《中国微创外科杂志》2002年第6期379-380,共2页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的　探讨胸腔镜术在晚期肺癌综合治疗中提高生存质量和延长生存时间的临床价值。方法　对 37例晚期肺癌在综合治疗中应用电视胸腔镜术施行姑息性手术治疗的结果进行分析。治疗前、后生活质量Karnofsky评分比较用t检验。生存率计算应用Kaplan -Meier法。　结果　恶性胸腔积液的完全缓解率达 10 0 % ,1年生存率为 80 8% ,2年生存率为 13 5 % ,平均生存期 18 0月 ,中位生存期19 0月。恶性心包积液的完全缓解率为 10 0 % ,1年生存率为 71 4% ,平均生存期 14 9月 ,中位生存期16 0月。周围型肺癌行肺楔形切除术病人的 1年生存率为 6 0 0 % ,平均生存期 14 4月 ,中位生存期16 5月。Karnofsky评分治疗前 (6 4 3± 2 1)分 ,治疗后 (89 7± 1 5 )分 ,差异有显著性 (t=9 87,P <0 0 1)。　结论　在晚期肺癌的综合治疗中应用电视胸腔镜术施行姑息性手术可有效的提高生活质量和延长生存时间。Objective To study the value of video-assisted thoracoscopic surgery in combined therapy for late lung cancer and its significance in the improvement of life quality and prolongation of survival time. Methods The results of 37 cases of late lung cancer who underwent palliative operation by video-assisted thoracoscope in combined therapy were analyzed.Karnofsky grade before and after the therapy were compared by t test.The survival rate was calculated by Kaplan-Meier method. Results The complete remission rate of malignant pleural effusion was 100%;the 1-year survival rate was 80.8% and the 2-year survival rate was 13.5% with mean survival time being 18.0 months and median survival time being 19.0 months.The complete remission rate of malignant pericardial effusion was 100%;the 1-year survival rate was 71.4% with mean survival time being 14.9 months and median survival time being 16.0 months.The 1-year survival rate was 60.0% for the patients suffering from peripheral lung cancer performed wedge resection of lung,with mean survival time being 14.4 months and median survival time being 16.5 months.Karnofsky grade before and after the therapy was (64 3±2 1)points and (89.7±1.5)points respectively ( t= 9.87,P <0.01). Conclusions The palliative operation with video-assisted thoracoscope can improve life quality and prolong survival time effectively in combined therapy for late lung cancer.

关 键 词：晚期肺癌 综合治疗 胸腔镜手术 生存质量 临床价值 

分 类 号：R734.2[医药卫生—肿瘤] R730.[医药卫生—临床医学]