本文選題：胸腔鏡　切入點(diǎn)：肺多發(fā)結(jié)節(jié)　出處：《福建醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：探討胸腔鏡在肺部多發(fā)結(jié)節(jié)診治中的應(yīng)用、手術(shù)方式的選擇及其預(yù)后。 方法：回顧性分析福建醫(yī)科大學(xué)附屬協(xié)和醫(yī)院胸外科2011年2月至2014年2月115例行胸腔鏡手術(shù)的肺部多發(fā)結(jié)節(jié)患者臨床資料。其中男性51例，女性64例，年齡18-83歲，平均（56±11）歲，綜合分析患者多發(fā)結(jié)節(jié)部位、手術(shù)方式、術(shù)后病理、術(shù)后并發(fā)癥及術(shù)后隨訪情況等。 結(jié)果：所有患者均完成胸腔鏡手術(shù)，其中同側(cè)多發(fā)結(jié)節(jié)51例，雙側(cè)多發(fā)結(jié)節(jié)64例，結(jié)節(jié)數(shù)2-6個(gè)不等；結(jié)節(jié)直徑0.3-3cm。全胸腔鏡114例，輔助小切口1例，無(wú)中轉(zhuǎn)開(kāi)胸，無(wú)圍手術(shù)期死亡。行胸腔鏡肺楔形切除65例，肺段切除10例，，肺葉切除38例，肺段+肺葉切除2例，無(wú)全肺切除手術(shù)病例。術(shù)后組織病理學(xué)提示惡性73例，其中原發(fā)性肺癌57例，轉(zhuǎn)移瘤16例；良性42例。手術(shù)平均176±78min，術(shù)中出血量平均102ml(10-700ml)，術(shù)后胸管留置時(shí)間平均3.77±2.23天，術(shù)后嚴(yán)重并發(fā)癥發(fā)生率1.74%（2/115），術(shù)后住院平均時(shí)間6.55±3.18天。隨訪2月-3年總體生存率96.04%（97/101），其中肺癌生存率91.2%。 結(jié)論：1.胸腔鏡手術(shù)在肺多發(fā)結(jié)節(jié)診治中具有重要作用，是一種切實(shí)可靠、安全、有效的診療措施。2.肺多發(fā)結(jié)節(jié)以肺癌、轉(zhuǎn)移瘤、肺結(jié)核、真菌感染、纖維化結(jié)節(jié)、炎性假瘤、肺內(nèi)淋巴結(jié)等常見(jiàn)。3.肺多發(fā)結(jié)節(jié)總體近期生存率高、生存質(zhì)量較好、復(fù)發(fā)轉(zhuǎn)移較低，應(yīng)積極處理。
[Abstract]:Objective: to explore the application of thoracoscopy in the diagnosis and treatment of multiple pulmonary nodules, the choice of surgical methods and prognosis. Methods: the clinical data of 115 patients with multiple pulmonary nodules underwent thoracoscopic surgery from February 2011 to February 2014 were retrospectively analyzed, including 51 males and 64 females, aged 18-83 years, with an average age of 56 鹵11 years. The location of multiple nodules, surgical methods, postoperative pathology, postoperative complications and postoperative follow-up were comprehensively analyzed. Results: all the patients underwent thoracoscopic surgery, including 51 cases of ipsilateral multiple nodules, 64 cases of bilateral multiple nodules, ranging in number from 2 to 6, the diameter of nodules ranged from 0.3 to 3 cm. Total thoracoscopy was performed in 114 cases, assisted small incision in 1 case, with no conversion to thoracotomy. No perioperative death. Thoracoscopic wedge resection was performed in 65 cases, segmental resection in 10 cases, lobectomy in 38 cases, lobectomy in 2 cases, and no total pneumonectomy. There were 57 cases of primary lung cancer, 16 cases of metastatic tumor, 42 cases of benign tumor. The average operation time was 176 鹵78 min, the average intraoperative bleeding was 102ml 10 ~ 700ml / L, the mean time of thoracic tube indwelling was 3.77 鹵2.23 days. The average postoperative hospitalization time was 6.55 鹵3.18 days. The overall survival rate was 96.04% / 101%, and the survival rate of lung cancer was 91.2%. Conclusion 1. Thoracoscopic surgery plays an important role in the diagnosis and treatment of multiple pulmonary nodules. It is a reliable, safe and effective diagnostic and therapeutic measure. 2. Lung cancer, metastatic tumor, pulmonary tuberculosis, fungal infection, fibrosis nodules, inflammatory pseudotumor. Pulmonary multiple nodules have high short-term survival rate, better quality of life, lower recurrence and metastasis, and should be actively dealt with.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R655

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 卜梁;李運(yùn);楊帆;趙輝;姜冠潮;李劍鋒;劉軍;王俊;;直徑大于5cm非小細(xì)胞肺癌患者行全胸腔鏡肺葉切除手術(shù)與開(kāi)胸手術(shù)療效的對(duì)比研究[J];北京大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2011年06期

2 廖美琳;肺癌多學(xué)科治療的新進(jìn)展[J];國(guó)外醫(yī)學(xué).呼吸系統(tǒng)分冊(cè);2005年02期

3 廉_g;;胸腔鏡肺癌根治術(shù)與傳統(tǒng)開(kāi)胸手術(shù)療效比較[J];中國(guó)醫(yī)藥導(dǎo)刊;2014年01期

4 施長(zhǎng)杲;呂維富;;中晚期肺癌的介入治療現(xiàn)狀及進(jìn)展[J];臨床肺科雜志;2011年02期

5 顧月清,廖美琳;老年腫瘤的流行病學(xué)和治療特點(diǎn)[J];老年醫(yī)學(xué)與保健;2002年02期

6 陳海濤,任健,車(chē)嘉銘,陳中元,邱維誠(chéng);老年肺癌的診治[J];老年醫(yī)學(xué)與保健;2005年01期

7 郭其森,賈慧;第12屆ECOO會(huì)議非小細(xì)胞肺癌內(nèi)科治療進(jìn)展概要[J];腫瘤防治雜志;2003年12期

8 劉輝國(guó);徐永健;;肺部多發(fā)結(jié)節(jié)性病變的診斷思路[J];中國(guó)實(shí)用內(nèi)科雜志;2007年13期

9 徐子迅;陳曲海;;肺楔形切除+縱隔淋巴結(jié)采樣治療在早期肺癌患者中的價(jià)值[J];中華全科醫(yī)學(xué);2012年11期

10 馬大慶;肺內(nèi)多發(fā)小結(jié)節(jié)的高分辨率CT鑒別診斷[J];中華放射學(xué)雜志;2001年09期

本文編號(hào)：1662466