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目的总结应用肺叶切除并肺动脉重建术治疗中心型肺癌的经验。方法回顾性分析自1995年9月至2006年8月,我院采用肺叶切除肺动脉重建术治疗中心型肺癌42例,其中24例肺动脉楔形切除后10例直接对拢缝合,14例用自体心包片修补;18例行肺动脉段袖式切除后6例直接吻合,5例用自体奇静脉移植,7例用自体心包片作成人工管道间置,恢复血管的连续性;同期有19例施行支气管成形术;术后有29例接受化疗,8例接受放疗。结果术后无死亡病例,并发肺炎7例,轻度肺不张4例,支气管残端漏1例,经治疗后均获痊愈。余者恢复良好,均顺利出院。结论肺叶切除肺动脉重建术治疗中心型肺癌能提高肺癌切除率,扩大手术适应证,最大限度保存患者的肺功能,是一种安全有效的手术方法。
Objective To summarize the experience of lobectomy and pulmonary artery reconstruction in the treatment of central lung cancer. Methods Retrospective analysis from September 1995 to August 2006, 42 cases of central lung cancer were treated by pulmonary lobectomy in our hospital. Among them, 24 cases were directly sutured after wedge resection in 24 cases and 14 cases were treated with autologous pericardium Repair; 18 cases of pulmonary artery segment after sleeve resection in 6 cases direct anastomosis, 5 cases with autologous azygos vein graft, 7 cases of autologous pericardium made of artificial inter-catheter placement, restoration of vascular continuity; the same period in 19 cases of bronchoplasty 29 patients received chemotherapy and 8 patients received radiotherapy. Results No postoperative death cases, complicated by pneumonia in 7 cases, mild atelectasis in 4 cases, bronchial stump leakage in 1 case, after treatment were cured. The rest recovered well and both were discharged smoothly. Conclusions Lobectomy and pulmonary artery reconstruction for central lung cancer can improve the resection rate of lung cancer, expand the indications for surgery, and maximize the lung function of patients. It is a safe and effective surgical method.