摘要
目的 探讨对支气管哮喘患者并发肺癌进行联合手术治疗的可行性。 方法 在根治性切除肺部肿瘤的同时 ,采用肺门神经彻底切断术治疗支气管哮喘。 1例右上叶周围型肺癌 ,行右上肺叶切除、淋巴结清扫的同时作同侧肺门迷走神经和交感神经的彻底切断。另 1例左上肺巨大中心型肺癌 ,行全肺切除后 ,摘出可保留的左下肺叶 ,采用自体肺移植技术将其重植于原左肺上叶位置。 结果 随访至 1999年 11月底 ,2例已分别存活 6年 8个月及 17个月。术后辅助通气分别为 4h及18h。术后哮喘发作频率减少、程度减轻 ,动脉血气分析和肺功能测定各项参数有轻度或明显改善 ,生活质量明显提高。 结论 对支气管哮喘引起肺功能差的肺癌患者不应一律视为手术禁忌症 。
Objective To assess surgery for lung cancer complicated by bronchial asthma. Methods Lung hilum denervation was performed for asthma during radical resection of lung cancer. One patient with peri pheral bronchogenic carcinoma in the right upper lobe underwent upper lobectomy and extensive dissection of lymph nodes. Simultaneously, lung hilum denervation was done by complets ampatation of the sympathetic and parasympathetic nerves around the lung hilum. Another patient with central bronchogenic carcinoma in the left upper lobe underwent lung autotransplantation. Pneumonectomy was performed, and the tumor parts of the lung were resected subseguantly and the preservable parts of the lung were replanted into the bed of the upper lobe. Results Follow up showed that the two patients had been alive with tumor free for 80 months and 17 months respectively and the time of postoperative mechanical ventilation was 4 and 18 hours. The frequency of asthma paroxysm decreased and the severity attenuated. Parameters of blood gas and lung function were improved. Conclusions The poor lung function caused by asthma should not be regarded as a contradiction for the remaval of lung cancer. Complete denevation around the lung hilum during the radical resection of lung cancer may contribute to the better treatment of lung cancer and asthma.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2000年第3期185-188,共4页
Chinese Journal of Surgery
关键词
哮喘
肺肿瘤
肺切除术
肺移植
并发症
Asthma
Lung neoplasms
Pneumonectomy
Lung transplantation
