重度阻塞性肺病患者食管癌切除同期肺减容手术临床探讨

目的　探讨重度阻塞性肺病患者食管癌切除同期肺减容手术 (lungvolumereductionsurgeryLVRS) ,手术方法及预后。方法　 2例重度肺气肿食管癌患者食管癌切除同期一侧肺减容手术 ,切除左肺上叶 1/ 3,下叶 1/ 3,切除一侧肺容量 30 %。术前术后肺功能、呼吸困难指数分级对比。结果　 2例病人均平稳渡过围手术期 ,呼吸困难部分改善 ,指数分级由Ⅲ级上升Ⅱ级 ,肺功能 1s肺活量FEV1增加 16% ,PaO2 增加 1 90kPa( 1 5mmHg)。结论　肺减容手术为部分重度阻塞性肺病患者提供了一种全新的治疗方法 ,为合并其它胸外科疾患 ,如食管癌平稳渡过围手术期 ,以及术后肺功能改善创造了条件

Clinical Discussion of Lung Volume Reduction Surgery in Tumor Resection of Esophageal Carcinoma Combined with Severe Obstructive Lung Disease

Objective To discuss the operative method and prognosis of esophageal carcinoma combined with severe obstructive lung disease (SOLD) treated with tumor resection and lung volume reduction surgery (LVRS). Methods 2 cases of such patients were underwent esophageal tumor resection while same side LVRS had been done (LU lobe 1/3 and LL lobe 1/3) about 30% of same side volume. The pulmonary functions and dyspnea index degree were compared. Results 2 cases got through perioperative stage safely and dyspnea of patients had partial improvement from index degree III to II. FEV1 increased 16% and PaO2 increased 1.5mmHg. Conclusion LVRS might a new operative method for part of SOLD and could supply the condition to pass the perioperative period safely and to improve the pulmonary function especially the patient combined with other thoracic disease such as esophageal carcinoma.