MVP方案对肺癌患者手术及病灶的影响

背景与目的术前化疗的相关不利影响增加手术的风险和难度,本研究旨在分析化疗后胸内组织结构变化,研究化疗对手术的具体影响,探讨化疗后外科处理特点并观察化疗后病灶组织形态学改变。方法选取随机入组肺癌患者100例,先手术组和先化疗组各50例。归纳化疗对患者胸内组织结构的影响;量化分析化疗对手术相关要素的影响及外科处理特点;观察部分化疗后病灶病理形态变化,探讨化疗临床缓解率与组织形态有效率的关系。结果化疗后,胸内相关组织出现不同程度的纤维化;手术时间、术中失血量及术后第1天引流量未见显著增多;化疗增加手术难度,娴熟的操作技巧足可避免手术风险;化疗后病灶呈现程度不同的病理组织形态学改变,与临床缓解率并不一致,2周期化疗的病灶组织形态学有效率明显高于1周期。结论化疗增加手术的难度,术中的耐心细致和手术技巧是避免风险的关键。术前化疗以2周期为宜。

Effects of MVP regimen on operation and cancer tisswes of Lung Cancer patients

Background and objective Preoperative chemotherapy increases the difficulty and risk of patients' operation.The aim of this study is to analyze the change of thoracic tissue,study the influence of chemotherapy to operation,discuss the special aspects of surgical management and observe the pathological change of focus after chemotherapy.Methods 100 patients were chosen and randomly divided into two groups(operation first group,50 cases;chemotherapy first group,50 cases).Some patient's pathological sections were observed to in- vestigate focus morphological influence of preoperative chemotherapy and the clinical response rate were compared with pathological response rate.Results It was showed that preoperative chemotherapy conduced different degree thoracic tissue fibrosis.Data statistics demonstrated that there were no significance difference of the operation time, blood loss during operation and drainage volume in first day after operation between two groups.The preoperative chemotherapy increased the difficulty of operation because of tissue fibrosis and scarification,but the risk could be avoided by skillful operation.In first operation group,there were various pathological changes in tumor tissue and the pathological response rate was not completely accordance with the clinical response rate.The focus pathological response rate of two cycles chemotherapy was more higher than that of one cycle chemotherapy.Conclusion Chemotherapy increases the risks of operation.Surgeons carefulness and better skills during operation are the key points to avoid the hazards of surgery.Two preoperative chemotherapy cycles are more suitable for the patients.