摘要
目的评价在肺或食管肿瘤手术中同期行肺减容术(LVRS)的可行性和效果。方法 45例肺肿瘤和37例食管肿瘤病人,随机分为甲组和乙组,甲组在肿瘤切除手术中同期行开胸侧 LVRS,根据术前胸部 CT、灌注通气肺扫描结果,确定肺无功能区,切除一侧肺叶的20%～30%;乙组为单纯肿瘤切除术组。随访6～12个月,对比手术前、后肺功能、血气、呼吸困难指数、6 min 行走距离(6MWD)等指标。结果两组均无围术期死亡,术后 FEV_1、PaO_2、PaCO_2、呼吸困难指数以及6MWD 甲组病人较术前改善,乙组较术前变化不明显或有轻度下降。结论对合并肺气肿的肿瘤病人,同期 LVRS 不仅增加了病人的手术机会,而且提高了病人术后生活质量。LVRS 扩大了肿瘤病人的手术适应证。
Objective To evaluate the feasibility and efficacy of tumor resection combined with lung volume reduction surgery （LVRS） in pulmonary and esophageal patients. Methods 45 patients with lung tumor and 37 patients with esophageal tumor were divided into group A（turaor resection plus LVRS） and group B（tumor resection only） randomly. Group A patients underwent tumor resection combined with LVRS. The target area was determined according to chest computed tomography and ventilation-perfusion scanning. The removed pulmonary tissues made up about 20% - 30% of the unilateral lung parenchyma. All patients were followed up for 6 - 12 months. The pulmonary function, blood gas, dyspnea index and 6-min walk distance were compared. Results There were no death during perioperative period. Forced vital capacity in 1 second, PaO2, PaCO2, dyspnea index and 6-min walk distance of the group A were all better than preoperative ones, while group B patients had no statistical difference or slight decrease. Conclusion For some tumor patients with emphysema, simultaneous LVRS might provide better opportunity for surgical treatment, but also improved the post-operative quality of life. It widens the operative indication for tumor patients.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2007年第5期314-316,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
关键词
肺气肿
肺肿瘤
食管肿瘤
肺切除术
Emphysema Lung neoplasm Esophageal neoplasm Pneumonectomy
