支气管袖状切除治疗中心型肺癌66例

目的:总结支气管袖状肺叶切除术治疗66例中心型肺癌的临床经验。方法:回顾性分析本院在1987年1月至2012年8月期间收治的中心型肺癌66例，其中TNM分期Ib期18例(T2N0M0)，Ⅱb期33例(T3N0M0)，Ⅲa期13例(T2N1M0)，IIIb期2例(T2N2M0)。支气管袖状肺叶切除51例，肺动脉和支气管双袖状肺叶切除15例。结果:手术死亡率1．5％(1／66)。术后并发肺不张4.5％(3／66)、脓胸1．5％(1／66)。术后随访1~60个月，1年生存率83．2％，3年生存率52.3％。结论:支气管或肺动脉袖状切除能提高中心型肺癌的手术切除率，并可最大限度保护肺功能，保证病人术后生活质量。

Experience of bronchial sleeve resection in the treatment of central lung cancer

Objective:To summarize the clinical experience of bronchial sleeve lobectomy in the treatment of 66 patients with central lung cancer.Methods:Retrospectively analysze 66 cases of lung cancer from January 1987 to August 2012.TNM stage Ib，18 cases （T2N0M0)，Ⅱb 33 patients （T2N1M0，T3N0M0），Ⅲa 13 patients （T2N1M0)，IIIb 2 cases （T2N2M0).Bronchial sleeve lobectomy was performed in 51 cases，pulmonary and bronchial sleeves like lobectomy in 15 cases.Results:The operative mortality was 1.5%（1/66).Postoperative pulmonary atelectasis accurd in 4.5%（3/66） in the totle，and empyema in 1.5%（1/66).They were followed up for 1 to 60 months，and 1-year survival rate was 83.2%，3-year survival rate was 52.3%.Conclusion:Bronchial or pulmonary artery sleeve resection can improve the central lung resection rate，and can maximize the protection of lung function to ensure patient quality of life after surgery.