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目的 总结低肺功能肺癌患者的术前肺功能、手术治疗方式和术后并发症 ,探讨术前肺通气功能检查在低肺功能肺癌患者手术治疗中的价值。方法 回顾性分析和总结低肺功能肺癌患者的治疗经验 ,并采用 χ2 检验进行统计。结果 181例中 ,全肺、肺叶、部分肺叶切除和探查者分别为43例、118例、16例和 4例。切除组术后总的并发症发生率为 42 .4% (75 / 177) ,总的住院死亡率为7.9% (14/ 177)。全肺、肺叶和部分肺叶切除后心肺并发症的发生率分别为 2 5 .6 % (11/ 43)、48.3%(5 7/ 118)和 31.3% (5 / 16 )。 8例术前行放疗和 (或 )化疗患者术后并发症发生率为 6 / 8,死亡率为 3/ 8。12例第 2次开胸手术患者术后并发症发生率为 6 6 .7% (8/ 12 ) ,死亡率为 33.3% (4 / 12 )。全组 1,3,5年生存率分别为 71.1% (32 / 45 )、42 .2 % (19/ 45 )和 31.1% (14/ 45 ) ;Ⅰ、Ⅱ、Ⅲ期的 5年生存率分别为 5 5 .0 %(11/ 2 0 )、2 5 .0 % (3/ 12 )和 0。结论 术前肺通气功能检查是低肺功能肺癌患者手术治疗的重要依据 ,但应结合病史、弥散功能和术前其他检查来综合判断。有术前放化疗史和对侧开胸手术史的低肺功能患者 ,术后心肺并发症和死亡率明显增加。对于早期的低肺功能肺癌患者应争取手术治疗。
Objective To summarize the preoperative pulmonary function, surgical treatment and postoperative complications in patients with lung cancer of low lung function and to evaluate the value of preoperative pulmonary ventilation in the surgical treatment of patients with lung cancer of low lung function. Methods The clinical experience of patients with lung cancer with low lung function was analyzed and summarized retrospectively. Chi-square test was used for statistics. Results Among the 181 cases, there were 43 cases, 118 cases, 16 cases and 4 cases of pneumonectomy, pulmonary lobectomy and partial lobectomy. The overall complication rate in the resection group was 42.4% (75 of 177) and the total in-hospital mortality was 7.9% (14 of 177). The incidence of cardiopulmonary complications after pulmonary lobectomy and partial lobectomy were 25.6% (11/43), 48.3% (57/18) and 31.3% (5/16), respectively. 8 cases of preoperative radiotherapy and / or chemotherapy patients with postoperative complications was 6/8, the mortality rate was 3 / 8.12 cases of second open-chest surgery patients postoperative complications was 6.67 % (8/12), the mortality rate was 33.3% (4/12). The 1, 3, 5-year overall survival rates were 71.1% (32/45), 42.2% (19/45) and 31.1% (14/45) respectively. The 5-year survival rates of stage I, Were 55.0% (11/20), 25.5% (3/12) and 0. Conclusions Preoperative pulmonary ventilation is an important basis for the surgical treatment of lung cancer patients with low lung function, but should be combined with history, diffuse function and other preoperative examination. Patients with a history of preoperative chemoradiation and contralateral thoracotomy history of low lung function, postoperative cardiopulmonary complications and mortality increased significantly. For early low-lung function lung cancer patients should seek surgical treatment.