摘要
目的 :探讨化疗对肺癌患者手术的具体影响。方法 :随机将 10 0例肺癌患者分为两组 :①术前化疗组 ,手术前先行化疗 ,再予手术 ,共 5 9例 ;②术后化疗组 ,先行手术 ,术后再予化疗 ,共 4 1例。绝大多数病例接受MVP方案化疗 ,周期数 1～ 6不等。术中观察两组患者胸内组织结构的变化。记录患者手术时间、术中失血量及术后第一日引流量等指标 ,运用SPSS软件分析之。结果 :①观察显示 :术前化疗导致肺癌患者胸膜、肿瘤周围组织、淋巴结纤维化 ,以肺动脉外膜及其附近组织最为明显 ,因而手术风险和难度明显增加。组织纤维化程度与化疗周期数有一定相关性。②术前化疗组手术时间略长 (P >0 0 5 ) ,术中失血量略多 (P >0 0 5 ) ,但均无统计学意义。③术后引流量两组无差异。结论 :化疗可增加肺癌患者手术的风险。针对纤维化 ,术中更细致的止血是减少术中 ,术后失血的主要手段。充足的化疗间隔 。
Purpose:To investigate the effects of chemotherapy on the patient's operation for lung cancer.Methods:One hundred patients were randomized into two groups. ①Preoperative chemotherapy group, the patients accepted chemotherapy first, then underwent operation, 59 cases;②postoperative chemotherapy group, the patients accepted the chemotherapy after operation, 41 cases. Most of the patients accepted the MVP chemotherapy regimen (1-6 course). All patients underwent operation of lobectomy or pneumonectomy. During the operation, the change of thorax structure was observed. Some indexes, which include operation time, blood loss during operation and postoperative drainage volume of first day, were recorded. The data were analysed with SPSS software.Results:①It is indicated that preoperative chemotherapy induce thoracic tissue fibrosis, which include pleura, the tissue around tumor and lymph nodes. The tissue fibrosis of pulmonary artery was most notable, which increase the risk and difficulty of operation .The serious grade of tissue fibrossis was related to the courses of chemotherapy. ②The operation time of preoperative chemotherapy group was longer than that of postoperative chemotherapy group ( P <0 05).③The blood loss of preoperative chemotherapy group was much more than that of postoperative chemotherapy group ( P >0 05).④There was no significant difference in postoperative drainage volume in the two groups.Conclusions:①Chemotherapy increases the patients′ operation risks for lung cancer;②Fibrosis is an underlying risk factor for blood loss, it is necessary to pay more attention to careful hemostasia during the operation. ③To decrease the risks of postoperative complication, sufficient interval after chemotherapy, preoperative preparation and proper management after operation are the key factors.
出处
《中国癌症杂志》
CAS
CSCD
2003年第5期408-410,共3页
China Oncology
关键词
肺癌
手术
化疗
外科处理
lung cancer
operation
chemotherapy
