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目的对肺原发性恶性淋巴瘤的临床症状、诊疗方法和预后情况进行探讨。方法对近10年我院收治的17例肺原发性恶性淋巴瘤患者的临床资料进行回顾性研究。我们对这17例患者行了CT检查、B超检查、支气管镜检查和病理检查,并根据患者的意愿及其病情特点,将他们分为手术组和化疗组,其中,手术组有11例患者(包括在手术后进行化疗的7例患者),化疗组有6例患者。我们对手术组的11例患者进行了开胸手术,并对其实施了根治性肺叶切除术及纵隔淋巴结清扫术,对化疗组的6例患者进行了CHOP化疗。治疗结束后,对这17例患者的诊疗情况进行研究,并对两组患者的生存率进行比较。结果经过临床诊疗我们发现,肺原发性恶性淋巴瘤患者主要可出现咳嗽、呼吸困难,胸闷、胸痛、发热等临床表现,但无特异性的临床症状,即使对其进行CT检查、B超检查和支气管镜检查,也很难对其病情进行确诊,故肺原发性恶性淋巴瘤的临床误诊率较高。进行病理检查是临床上诊断肺原发性恶性淋巴瘤最可靠的方法。经过治疗,手术组患者的半年生存率和一年生存率与化疗组患者相比无显著性差异(p>0.05),而手术组患者的五年生存率明显高于化疗组患者,二者相比差异具有显著性(P<0.05)。结论目前临床上诊断肺原发性恶性淋巴瘤的难度较大,需要在进行病理检查的基础上,对各项检测结果进行综合判断。进行手术治疗和化疗是目前临床上治疗肺原发性恶性淋巴瘤的主要方法,其中进行手术治疗可以有效地提高此病患者的五年生存率。
Objective To investigate the clinical symptoms, diagnosis and treatment and prognosis of primary malignant pulmonary lymphoma. Methods The clinical data of 17 patients with primary malignant lymphoma of lung treated in our hospital in recent 10 years were retrospectively studied. We performed CT, B-ultrasound, bronchoscopy and pathology on these 17 patients and divided them into operation group and chemotherapy group according to patients’ wishes and their disease characteristics. Among them, 11 patients (Including 7 patients who underwent chemotherapy after surgery) and 6 patients in the chemotherapy group. We performed thoracotomy in 11 patients in the surgery group and underwent radical lobectomy and mediastinal lymph node dissection. Six patients in the chemotherapy group were treated with CHOP chemotherapy. After treatment, the treatment of these 17 patients were studied, and the survival rate of two groups of patients were compared. Results After clinical diagnosis and treatment, we found that patients with primary pulmonary malignant lymphoma may have clinical manifestations such as cough, dyspnea, chest tightness, chest pain and fever, but no specific clinical symptoms. Even if they were examined by CT, B-ultrasound And bronchoscopy, it is difficult to diagnose their condition, so the high rate of clinical misdiagnosis of primary malignant lymphoma of lung. Pathological examination is clinically the most reliable method for the diagnosis of primary pulmonary malignant lymphoma. After treatment, the half-year survival rate and one-year survival rate of patients in the operation group were not significantly different from those in the chemotherapy group (p> 0.05), while the five-year survival rate of the operation group was significantly higher than that of the chemotherapy group The difference was significant (P <0.05). Conclusions At present, it is more difficult to diagnose primary malignant lymphoma of lung in clinic. It is necessary to make a comprehensive judgment of the results based on the pathological examination. Surgical treatment and chemotherapy are the main methods for the clinical treatment of primary malignant lymphoma of lung. Surgical treatment can effectively improve the five-year survival rate of patients with this disease.