冠脉支架植入术后3周内行肺癌根治术的可行性研究

目的探讨合并有严重冠脉狭窄行冠脉支架植入术后3周内行肺癌根治术的可行性。方法回顾2008年12月-2010年12月我科对合并有严重冠脉狭窄并行冠脉支架植入术（PCI）患者3周内试行常规小切口肺叶切除术10例病例。并将此10例患者临床资料与我科近年所行常规小切口肺叶切除患者（LAT）临床数据行对比研究。结果 10位患者共植入27枚支架,其中Cypher植入10枚,Firebird植入9枚,Partner植入8枚。血管分布为左前降支13枚,左回旋支8枚,右冠状动脉6枚。手术成功率为100%,狭窄程度由术前80-100%降至5%;10例中右肺上叶1例,右肺中下叶2例,右肺下叶1例,左肺上叶5例,左肺下叶1例。全部患者手术过程顺利,术后病理证实均为恶性肿瘤。PCI组肺叶切除时间,术中出血量、住院时间与LAT组比较无统计学意义,虽然术后胸腔引流量及拔管时间略增加,但PCI组开胸术中术后均未出现明显出血征象。结论我们证实在合理应用好抗凝药物、做好围手术期准备工作的前提下,冠脉支架植入术后短期内行肺叶切除术是安全可行的,有条件甚至可以考虑杂交手术。

Feasibility of radical operation for lung cancer 3 weeks after coronary stent implantation

Objective To study the feasibility of radiacal operation for lung cancer accompanying severe coronary stenosis 3 weeks after coronary stent implantation.Methods Ten patients with lung cancer accompanying severe coronary stenosis who underwent lobectomy 3 weeks after coronary stent implantation in our hospital from December 2008 to December 2010 were reviewed.Their clinical data were compared with those about the patients who underwent routine small incision lobectomy.Results Of the 27 stents implanted in th...