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目的总结应用ＫＴＰ／ＹＡＧ双波长激光配合胸外科手术治疗肺癌的经验。方法１９９５年５月以来为４５例肺癌患者（周围型肺癌３９例，单侧肺转移癌４例，双肺转移癌２例，肿瘤直径１．４～５．７ｃｍ）行激光手术。应用进口ＫＴＰ／ＹＡＧ双波长激光治疗机，ＫＴＰ激光波长５３２ｎｍ，Ｎｄ∶ＹＡＧ激光波长１０６４ｎｍ。术中根据不同病灶及组织结构，分别选择１２～１５Ｗ的ＫＴＰ激光或３０～６０Ｗ的Ｎｄ∶ＹＡＧ激光对肺叶或肺段肿瘤进行分离切除，对转移浸润的肺门与纵隔淋巴结行凝固汽化治疗。结果４５例肺癌患者激光手术切除癌灶８３个，创面几无出血。手术出血量约１５０～２００ｍｌ。术后胸腔引流总血量５０～８０ｍｌ。１例因胸腔内残腔较大，拔管后第３天胸腔穿刺抽出２１０ｍｌ淡红色液体，其余病例无需胸腔穿刺抽液。胸腔引流管拔除时间为术后２０～２４ｈ。２０例患者术中肺鼓气检查示肺断面有不同程度肺泡漏气，用Ｎｄ∶ＹＡＧ激光补充照射融合肺泡后漏气停止，极少数残留小支气管未闭合者行结扎或缝合关闭，术后１周摄Ｘ线胸片未见气胸及肺不张征象。２例术后咳血痰２～３天，经对症治疗而愈。术后患者体温一般不超过３８℃。无并发症出现，临床疗效满意。结论术中激光的应用使肺组?
Objective To summarize the experience of KTP/YAG dual-wavelength laser combined with thoracic surgery for lung cancer. Methods Since May 1995, 45 patients with lung cancer (39 cases of peripheral lung cancer, 4 cases of unilateral lung metastases, 2 cases of metastatic lung cancer, tumor diameter 1.4-5.7 cm) underwent laser surgery. The application of imported KTP/YAG dual-wavelength laser treatment machine, KTP laser wavelength 532nm, Nd: YAG laser wavelength 1064nm. According to different lesions and tissue structure, 12-15W KTP laser or 30-60W Nd∶YAG laser was selected to separate and remove lung or lung tumors, and metastatic infiltrating hilar and mediastinal lymph nodes were coagulated and vaporized. Results Forty-five patients with lung cancer underwent laser resection of 83 lesions with few bleeding wounds. The amount of blood loss is about 150-200ml. After chest drainage total blood volume 50 ~ 80ml. In 1 case, because of a large residual cavity in the chest, 210 ml of light red liquid was punctured on the third day after extubation, and no thoracentesis was needed for the remaining cases. The removal time of chest drainage tube was 20-24 hours after operation. Twenty patients underwent intraoperative lung airway examination with different degrees of alveolar leak in the lung section. After the fusion of the alveoli was supplemented with Nd:YAG laser, the air leak stopped. A small number of remaining small bronchi was not closed and was closed by ligation or suture. There were no signs of pneumothorax or atelectasis in the X-ray chest radiographs. Two cases of hemoptysis 2 to 3 days after surgery, the more symptomatic treatment. Postoperative patient temperature does not exceed 38°C. No complications occurred and the clinical efficacy was satisfactory. Conclusions Intraoperative laser application to the lung group?