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1989年10月～1997年9月,我院选择5例以脑转移为首发临床表现的肺癌患者实施了外科治疗,现报告如下: 1 临床资料 1.1 一般资料 男4例,女1例,年龄51～66岁:全组为周围型肺癌,左肺3例,右肺2例,转移癌灶发生右脑3例,左脑2例。主要表现为头痛4例,伴有恶心、呕吐2例,肢体活动障碍者1例,肺部肿瘤经胸部X线检查发现,占同期肺癌手术的1.7％(5/302)。 1.2 治疗与结果 3例先行肺原发灶切除,后开颅转移癌摘除,2例恶心、呕吐颅内压增高者先行开颅转移癌切除,再行肺癌切除。单纯肺叶切除3例,双肺叶加楔形切除各1例。肺部原发病灶与脑转移灶经病理学检查明确诊断,其中腺癌4例,腺鳞癌1例。3例术后接受化疗。术后随访生存11个月～3年,平均19个月。
October 1989 ~ September 1997, our hospital chose 5 cases of brain metastases as the first clinical manifestations of lung cancer patients underwent surgical treatment, are as follows: 1 Clinical data 1.1 General information 4 males and 1 female, age 51 ~ 66 years old: the whole group of peripheral lung cancer, left lung in 3 cases, right lung in 2 cases, metastasis foci occurred in 3 cases of right brain and left brain in 2 cases. Mainly for the 4 cases of headache, accompanied by nausea, vomiting in 2 cases, 1 case of limb movement disorders, lung cancer by chest X-ray examination, accounting for the same period of lung cancer surgery 1.7% (5/302). 1.2 Treatment and results of 3 cases of primary lung resection, after craniotomy metastatic cancer removal, 2 cases of nausea, vomiting increased intracranial pressure were removed craniotomy metastasis, resection of lung cancer. Simple lobectomy in 3 cases, double lobe plus wedge resection in 1 case. Primary lung lesions and brain metastases by the pathological examination of a clear diagnosis, including adenocarcinoma in 4 cases, 1 case of adenosquamous carcinoma. Three patients underwent chemotherapy. Survival follow-up 11 months to 3 years, an average of 19 months.