摘要
目的探讨肺癌伴癌性胸水患者肺切除或冷冻治疗问题。方法肺癌伴癌性胸水２１例（肺腺癌１１例，鳞癌８例，鳞腺癌２例），施行肺切除１４例，术后胸水均消失，术后化疗；７例剖胸未能切除病肺，用液氮冷冻肺肿瘤及胸膜上癌结节，术后化疗。结果肺切除者生存率１年６７％，２年２５％，３年８％，未切除病肺冷冻治疗者生存率接近前者。结论肺切除术中结合冷冻治疗，术后化疗或放疗，可进一步提高疗效。
Objective To asses the value of surgical treatment of lung cancer associated with pleural effusion.Metheds Among 21 patients with lung cancer associated with malignant pleural effusion,14 cases were treated by excision, Results In this group,lobectomy was performed in 7 cases,bilobectomy in 4,and total pneumonectomy in 3,the 1￣,2￣and 3￣years survivalrates were 67%, 25%and 8% respectively, The pleural effusion disappeared in all 14 cases after operation,7 cases treated by lobectomy and adjuvant chemoradiotherapy after operation survived over 1 year,2 of them over 2 years,1 remained alive and well for 3 years.7 cases with inoperable cancer at the time of exploratory thoracotomy were treated by cryotherapy (liquid nitrogen).In this group. 4 cases survived over 1 year,1 patient over 2 years. Conclusion The indication of exploratory thoracotomy should be:non-small cell lung cancer,no evidence of distant metastasis,no encapsulated pleural effusion,higher probability of tumor resection,and betters condition of the patient to tolerate pulmonary resection.
基金
福建省科委重点项目
关键词
肺肿瘤
癌
癌性胸水
肺切除
冷冻疗法
lung cancer malignant pleural effusion lobectomy cryotherapy
