肺叶切除加体外循环下左房内癌栓摘除术及文献复习

【目的】探讨体外循环（cardio pulmonary bypass,CPB）在侵犯心脏及大血管的肺局部晚期恶性肿瘤切除手术中的应用。【方法】左肺下叶周围型肺癌并左房内癌栓1例,左第5肋间前外切口进胸,处理左下肺动脉,左股动静脉转流建立CPB,心脏停搏下摘除左房内癌栓,撤除CPB,行左下肺叶切除。【结果】CPB转流平稳,自动复跳,停机顺利;术后机械辅助通气12h后拔除气管插管,72h拔除胸腔引流管,术后恢复顺利,10个月后仍存活。【结论】对于侵犯心脏及大血管的局部晚期肺肿瘤,CPB的应用扩大了手术指征,保证了麻醉和手术的安全,有助于实行肺癌根治性切除。

Pulmonary lobectomy and resected the intracardial carcinomous embolism by cardiopulmonary bypass : a case report and review of literatures

【Objective】To investigate the application of cardiopulmonary bypass （CPB） in the treatment of locally advanced pulmonary malignant tumors invaded heart or great vessels.【Methods】We received a case of advanced left lower peripheral lung cancer with intracardial carcinomous embolism. Through the 5th left intercostal space, we treated the left lower arteria pulmonalis, and CPB was established through the left arteria cruralis and vein, and with arrest of the heart, we resected the intracardial carcinomous embolism, then withdrew CPB, we carried out the left lower pneumonectomy.【Results】CPB was smooth, and heart automatically rebeated. Maintained mechanical ventilation for 12 h, 72 h later exelcymosis the thoracic drainage tube. The patients has survived over 10 months. 【Conclusions】To locally advanced pulmonary malignant tumors invaded heart or great vessels,CPB could guarantee the safety of anesthesia and surgery,and be helpful for completely removal.