胸腔镜切除术治疗肺多发结节患者的近期疗效及预后生存分析
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四川省卫生厅科研课题(120206)


Short term effects and survival analysis of thoracoscopic resection in treating patients with multiple nodules
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    【摘要】 目的 探讨胸腔镜切除术治疗肺多发结节患者的临床疗效及对预后生存的影响。方法 纳入2008年1月~2015年5月收治的86例胸腔镜下行手术治疗的肺多发结节患者的临床及随访资料,分析患者结节大小、数量及部位、手术方式、手术时间、术中出血量、术中淋巴结清扫数、术后病理诊断、并发症的发生、住院时间、临床疗效以及出院后3月~7年的随访情况。结果 手术患者中并发症发生率较低,相比较而言,肺部感染发生率最高(349%),最少为皮下气肿(12%)。病理诊断良性肿瘤28例,良性肿瘤中女性(6例)明显低于男性(21例),两者比较差异有统计学意义(P<005);恶性肿瘤58例,恶性肿瘤中女性(39例)明显高于男性(19例),两者比较差异有统计学意义(P<005)。出院患者随访中失访7例,实际生存率为965%,在原发性肺癌中早期肺癌预后较好,无死亡;在转移瘤中,除结肠癌患者预后稍差外,余患者预后均为良好。不同类型疾病患者生活质量均明显较高,其中良性肿瘤预后最好,原发性肺癌中除合并鳞癌患者生活质量相对稍差外,余均可。结论 胸腔镜切除术对肺部多发结节疾病的诊治具有重要作用,临床疗效好,术后并发症发生率及复发转移率较低,总体生存率高,生活质量好,可作为临床治疗肺部多发结节的一种安全有效的诊治措施。

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    【Abstract】 Objective To investigate the shortterm effects and survival analysis of thoracoscopic resection in treating patients with multiple nodules. Methods 86 patients with multiple nodules in our hospital from January 2008 to May 2015 were selected and retrospectively analyzed. The nodule size, quantity, location, surgery method, surgery time, intraoperatve blood soss, lymph gland cleaning number, postoperative pathological diagnosis, postoperative complications, post operation hospitalization duration, clinical effect, follow up after 3 months7 years of all patients were statistically analyzed. Results The complication rate was lower in all patients after surgery. The lung infection rate was the highest (349%) and the pneumoderm was the least (12%). 28 cases were benign tumor including 6 women and 21 ment (P<005). 58 cases were malignant tumorincluding 39 women and 19 men (P<005). Patients with different surgery methods all achieved better clinic effect. In follow up, the actual survival rate was 965%. In primary lung cancer, prognosis of early tumor was better, no death occurred. In metastatic tumor, expect for colon cancer, other patients all had better prognosis. Life quality of patients with different kinds of illness were higher, and prognosis of benign tumors was the best, malignant tumor was common, ordinary lung cancer gland+squamous carcinoma was the least.Conclusion Thoracoscopic resection has significant effect in treating patients with multiple nodules, postoperative complications, high total survival rate, and better life quality.

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  • 在线发布日期: 2017-08-03
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