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1、全胸腔卧肺叶切除术34例llffl粉析2018-03-2910:29:48中国现代医生2018年5期刘旭武云鹏马秉灵[摘要]目的探讨全胸腔镜下肺叶切除术治疗肺部疾病的临床体会及临床应用价值。方法2015年10月〜2017年6月,我院共为34例肺部疾病患者行全胸腔镜下肺叶切除术,并对26例恶性肿瘤患者实施肺门及纵膈淋巴结清扫术。其中行左肺上叶切除们例,左肺下叶切除6例,右肺上叶切除8例,右肺中叶切除2例,右肺下叶切除7例,术后常规放置一根胸腔引流管。结果全组患者手术顺利,无围手术期死亡,无中转开胸,无严重并发症发生。平均
2、手术吋间(142.8±11.2)min,术中出血量(77.4±26.7)mL,术后胸腔引流管放置时间(5.4±1.3)d,清扫淋巴结数目(15.4±3.1)枚,术后住院吋间(8.7±2.6)de随访3〜16个月,1例IIb期腺癌患者在术后7个月发生转移,其余患者无复发及转移。结论全胸腔镜下肺叶切除术治疗肺部疾病具有创伤小、痛苦少、恢复快等优点,具有重要的临床应用价值。[关键词]全胸腔镜;肺叶切除术;肺部疾病;价值[中图分类号]R655[文献标识码]B[文章编9]1673-9701(2018)05-0051-03[Abs
3、tract]ObjectiveTodiscussclinicalexperieneeandapplicationvalueofpulmonarydiseasetreatedbyvideo-assistedthoracoscopicpulmonarylobectomy.MethodsSinceOctober2015toJune2017,34patientswithpulmonarydiseaseweretreatedwithvideo-assistedthoracoscopicpulmonarylobectomyinou
4、rhospital,and26malignanttumorpatientsweregivenhilarandmediastinallymphnodedissection.Therewere11casesofleftlungsuperiorlobectomy,6casesofleftlunginferiorlobectomy,8casesofrightlungsuperiorlobectomy,2casesofrightlungmiddlelobectomy,and7casesofrightlunginferiorlob
5、ectomy.Aintrathoracictubewasplacedafteroperationinroutineprocess・ResultsOperationsweresuccessfulinallpatients,andtherewerenoperioperativedeaths,transferthoracotomyorseriouscomplications.Themeanoperationtimewas(142.8±11.2)min,andtheoperativebloodlossamountwas(77.
6、4±26.7)mL.Thepostoperativeintrathoracictubeplacementtimewas(5.4±1.3)d,andlymphnodedissectionnumberwas(15.4±3.1),andpostoperativehospitalizationtimewas(8.7±2.6)d・Thepatientswerefollowedupfor3-16months.Metastasisoccurredin1caseofadenocarcinomainphraseIIb,andnopali
7、ndromiaandmetastasisinotherpatients.ConclusionVideo-assistedthoracoscopicpulmonarylobectomyintreatmentofpulmonarydiseasehastheadvantagesoflesstrauma,lesspainandfasterrecovery,whichhasimportantclinicalapplicationvalue・[Keywords]Video-assistedthoracoscope;Pulmonar
8、ylobectomy;Pulmonarydisease;Value近年來,随着医疗水平的不断提高和医疗器械的快速更迭,电视胸腔镜手术(videoassistedthoracoscopicsurgery,VATS)在胸外科领域也得到了迅猛的发展,并H逐渐成为胸外科主流的手术方式,其较传统开胸手术的优越性,也逐步得到广大胸外科医师的青