逆行切除在肺癌手术治疗中的应用  

Retrograde Resection Appliance in Lung Cancer Operative Treatment

作　　者：华新民[1] 刘建阳[1] 任宪伟[1] 刘炀[1] 李志杰[1] 张春江[1] 刘枫林[1] 徐立[1] 高锐[1] 王佳铭[1] 刘宇光[1] 

机构地区：[1]吉林省肿瘤医院胸一科,长春130012

出　　处：《实用肿瘤学杂志》2003年第2期102-104,共3页Practical Oncology Journal

摘　　要：目的 探讨提高肺癌手术切除率的方法。方法 在某些特定因素,改变肺切除术中常规首先处理肺血管再切断支气管的方法,可在肺动、静脉处理前或中间切断支气管即逆行切除术,由于离断了坚硬无延展性的支气管联系,而仅留有血管及结缔组织,使肺门松动延展便于进一步处理,可以大幅度提高肺癌手术切除率。结果 将肺癌病人随机分二组,临床组(行逆行肺切除组):共516例,对照组(不行逆行肺切除组):498例。讨论 两组病人的手术切除率及生存率临床组均高于对照组,手术并发症发生率特别是心肺并发症发生率显著低于对照组,故手术死亡率亦明显下降。结论 逆行肺切除技术是提高肺癌手术切除率及生存率的可行方法。Objective To discuss the method of increasing resection rate of lung cancer. Methods Under some certain circumstances we can cut off the bronchus before or in the course of pulmonary artery and vein dissecting and ligating pulmonary instead of routine method of dissecting and ligating pulmonary vessels first followed by amputating bronchus. We can loosen hilus to make it ductile by which contributes to further operation as a result of having cut off the connection with hard and inductile bronchus whereas remaining blood vessel and connective tissue. The resection rate of lung cancer is increased significantly accordingly (to see attached operation course graphs) . Results Patients of lung cancer were divided into two groups at random: clinical group(lung resected by retrograde method group), 516 cases; contrast group (lung resected by non- retrograde method group), 498 cases, respectively. Both the resection rate and the survival rate in clinical group patients are higher than those of in contrast group, the incidences of operative complications especially of heart and/or lung are remarkable lower than those of contrast group, the operative mortality decreased accordingly. Conclusion Retrograde resection is a feasible method to increase operative resection rate and survival rate of lung cancer patients. It can receive the effect of radical operation even though it looks like a palliative treatment method.

关 键 词：肺癌 逆行切除 手术治疗 临床应用 生活质量 生存率 

分 类 号：R734.2[医药卫生—肿瘤] R730.56[医药卫生—临床医学]