中国现代医生
中國現代醫生
중국현대의생
CHINA MODERN DOCTOR
2014年
25期
125-127
,共3页
孤立性肺结节%微创%早期肺癌%胸腔镜肺叶切除术
孤立性肺結節%微創%早期肺癌%胸腔鏡肺葉切除術
고립성폐결절%미창%조기폐암%흉강경폐협절제술
Solitary pulmonary nodules%Minimally invasive%Early lung cancer%Thoracoscope lung resection
目的：通过分析孤立性肺结节(solitary pulmonary nodules，SPN)患者的诊疗过程，总结SPN微创化诊治模式的建立。方法对健康体检或临床检查发现的68例SPN患者进行程序化微创诊治，分析诊治过程。结果68例SPN患者经CT定位肺穿刺活检证实为肺恶性肿瘤的13例(19.1%)。胸腔镜肺结节切除证实为肺恶性肿瘤的2例(2.9%)。胸腔镜肺叶切除术16例，其中淋巴结清扫15例，术中出血50~800(344.7±222.5)mL，术后住院时间8~18(11.9±2.9)d，胸腔闭式引流管留置时间3~8(4.9±1.7)d；单纯胸腔镜肺结节切除术9例，术中出血30~200(90.3±54.3)mL，术后住院时间5~19(9.1±4.2)d，胸腔闭式引流管留置时间1~16(4.3±4.6)d。结论微创化诊治相较传统诊疗方式有其优点存在，是治疗SPN的趋势。但目前尚无普遍共识，需要建立程序化的微创诊治模式。
目的：通過分析孤立性肺結節(solitary pulmonary nodules，SPN)患者的診療過程，總結SPN微創化診治模式的建立。方法對健康體檢或臨床檢查髮現的68例SPN患者進行程序化微創診治，分析診治過程。結果68例SPN患者經CT定位肺穿刺活檢證實為肺噁性腫瘤的13例(19.1%)。胸腔鏡肺結節切除證實為肺噁性腫瘤的2例(2.9%)。胸腔鏡肺葉切除術16例，其中淋巴結清掃15例，術中齣血50~800(344.7±222.5)mL，術後住院時間8~18(11.9±2.9)d，胸腔閉式引流管留置時間3~8(4.9±1.7)d；單純胸腔鏡肺結節切除術9例，術中齣血30~200(90.3±54.3)mL，術後住院時間5~19(9.1±4.2)d，胸腔閉式引流管留置時間1~16(4.3±4.6)d。結論微創化診治相較傳統診療方式有其優點存在，是治療SPN的趨勢。但目前尚無普遍共識，需要建立程序化的微創診治模式。
목적：통과분석고립성폐결절(solitary pulmonary nodules，SPN)환자적진료과정，총결SPN미창화진치모식적건립。방법대건강체검혹림상검사발현적68례SPN환자진행정서화미창진치，분석진치과정。결과68례SPN환자경CT정위폐천자활검증실위폐악성종류적13례(19.1%)。흉강경폐결절절제증실위폐악성종류적2례(2.9%)。흉강경폐협절제술16례，기중림파결청소15례，술중출혈50~800(344.7±222.5)mL，술후주원시간8~18(11.9±2.9)d，흉강폐식인류관류치시간3~8(4.9±1.7)d；단순흉강경폐결절절제술9례，술중출혈30~200(90.3±54.3)mL，술후주원시간5~19(9.1±4.2)d，흉강폐식인류관류치시간1~16(4.3±4.6)d。결론미창화진치상교전통진료방식유기우점존재，시치료SPN적추세。단목전상무보편공식，수요건립정서화적미창진치모식。
Objective To analyze the treatment process of solitary pulmonary nodules (SPN) to establish a minimally invasive treatment model of SPN. Methods A total of 68 cases of patients with SPN were taken programmatic minimally invasive treatment. The diagnostic and treatment process was analyzed. Results 68 cases of patients with SPN were taken biopsy under CT. localization. 13 cases (19.1%) were confirmed to be pulmonary malignant tumor. 2 cases of pulmonary malignant tumor (2.9%) were confirmed by thoracoscope lung nodule resection. 16 cases were taken thoracoscope lung resection and 15 cases in the 16 cases were taken mediastinal lymph nodes dissection. The intraoperative bleeding was 50-800 (344.7±222.5) mL. The postoperative hospital stay was 8-18 (11.9±2.9) d. The thoracic drainage tube indwelling time were 3-8 (4.9±1.7)d. 9 cases were taken pure thoracoscope lung nodule resection, and the intraoperative bleeding were 30-200(90.3±54.3)mL, the postoperative hospital stay were 5-19(9.1±4.2)d, the thoracic drainage tube indwelling time were 1-16 (4.3±4.6)d. Conclusion Minimally invasive treatment is the trend for the treatment of SPN compared with the traditional treatment. It is necessary to establish a procedural model of minimally invasive treatment.
