非小细胞肺癌42例剖胸探查的原因分析及体会

目的探讨非小细胞肺癌剖胸探查不能切除的原因，总结规律，提高手术切除率。方法回顾性分析42例临床资料，重点分析胸部CT、三探头脱氧葡萄糖符合线路断层显像（SPECT）检查结果，以及症状、病程等因素。结果4年来我科剖胸探查率8．1％，其无法切除的原因分别为：肺门、纵隔重要结构受累，肺内、胸膜多发转移，因肺功能差或其他伴随症而无法耐受扩大切除。结论术前CT、SPECT检查对于肺门、纵隔情况有重要参考价值；周围型肺癌伴刺激性咳嗽，应考虑到肺内多发转移的可能。

Exploration for reasons of unresectable exploratory thoracotomy in 42 patients with NSCLC

Objective To discuss the reasons for unresectable NSCLC after exploratory thoracotomy, to find out the rules, and to raise the rate of excision. Methods The clinical data of 42 cases were retrospectively reviewed and analyzed for the result of chest CT scanning and SPECT imaging and symptoms and course of the disease. Results The rate of exploratory thoracotomy in this department is 8.1% in recent 8 years. The in- volvement of hilum of lung or mediastinum, multiple metastases in lungs or pleurae and poor pulmonary function or other accompanied diseases were main reasons for unable performance of further extended resection. Conclusion CT scanning and SPECT imaging are valuable measures for assessment of the status of hilum of lung and mediastinum before operation. Peripheral lung cancer accompanied with irritable coughing may be the sign for multiple metastases in lungs.