摘要
目的探讨人造血管肺动脉重建术治疗肺动脉主干受侵犯的中央型肺癌的可行性及优越性。方法收集昆明医科大学第一附属医院胸外科于2001年1月至2012年2月期间收治的32例肺动脉主干受侵犯的中央型肺癌患者的临床资料，术前病理分期显示Ⅲa期12例，Ⅲb期19例，Ⅳ期1例。采用人造血管肺动脉重建术治疗，并从手术可行性、手术技巧及手术的优缺点方面进行总结。结果全组无死亡病例，31例患者术后7～10d出院；1例患者术后出现支气管胸膜瘘，治疗20d后出院。术后最远期患者随访3年，均未发现重建血管内有血栓形成及血流受阻情况。术后1、2、3年局部复发率分别为6．3％、9．4％和3．1％，远处转移率分别为6．1％、6．3％和6．3％。32例患者中，鳞状细胞癌22例，腺癌10例，两组1、2、3年的生存率比较差异无统计学意义（χ2=6．48，P=0．15；χ2=7．82，P=0．11；χ2=6．76，P=0．12）。结论人造血管肺动脉重建术治疗肺动脉主干受侵犯的中央型肺癌减少了全肺切除术的施行，最大限度地保留了患者的健康肺叶，手术治疗效果佳，创伤较全肺切除小。
Objective To investigate the feasibility and superiority of pulmonary artery reconstruction by artificial blood vessels in treatment of central bronchogenic carcinoma with pulmonary artery stem involvement. Methods The data of 32 cases of central bronchogenic carcinoma with pulmonary artery stem involvement hospitalized in Department of Thoracic Surgery in the First Affiliated Hospital of Kunming Medical University between January 2001 and February 2012 were retrospectively analyzed. Preoperative pathological examinations indicated that there were 12 cases in stage Ⅲa, 19 cases in W b and 1 case in stage IV. All patients received pulmonary artery reconstruction by artificial blood vessels. The feasibility, technique and superiority of the procedure were summarized. Results Among these 32 cases, no postoperative death occurred, 31 cases discharged 7 to 10 d after operation, and the other 1 discharged 20 d after operation due to postoperative bronchopleural fistula. Patients were followed up as long as 3 years, and no thrombosis and blood flow obstruction was found in the reconstructed artificial blood vessels. The 1-year, 2-year and 3-year postoperative local recurrence rates were 6.3%, 9.4% and 3.1%, respectively, and the 1-year, 2-year and 3-year postoperative metastasis rates were 6.1%, 6.3% and 6.3%, respectively. In these 32 cases, there were 22 cases of squamous carcinoma and 10 cases of adenocarcinoma, and there was no significant difference in 1-year, 2-year and 3-year survival rates between these two groups（χ2= 6.48, P = 0. 15 ; χ2= 7.82, P =0. 11 ; χ2= 6.76, P
出处
《中华胸部外科电子杂志》
2015年第2期105-109,共5页
CHINESE JOURNAL OF THORACIC SURGERY：Electronic Edition
基金
云南省科技计划项目联合专项(2010CD160)
关键词
中央型肺癌
肺动脉重建
人工血管
Central bronchogenie carcinoma
Pulmonary artery reconstruction
Artificial blood vessel
