【摘要】：目的總結(jié)分析肺CT檢查發(fā)現(xiàn)的磨玻璃結(jié)節(jié)(GGO)的外科診斷和治療特點。方法回顧性納入2013年1月至2016年12月在四川大學華西醫(yī)院胸外科行手術切除治療的肺GGO患者,總結(jié)其手術前、手術中以及手術后的臨床資料,分析GGO的外科診治特點。結(jié)果共納入663例患者,手術后病理證實為惡性病變者614例,惡性比例為92.6%。良性GGO組病變直徑小于惡性GGO組[(0.8±0.2)cm vs.(1.5±0.8)cm,P0.001]。惡性GGO組患者在胸部CT出現(xiàn)邊界不清征象的比例高于良性GGO組(93.8%vs.20.4%,P0.001),而兩組患者在空泡征、胸膜牽拉、毛刺和分葉征象上差異無統(tǒng)計學意義(P0.05)。652例(98.3%)患者行胸腔鏡手術,僅11例(1.7%)患者行開放手術。336例(50.7%)患者行肺葉切除術,226例(34.1%)患者行肺段切除術,101例(15.2%)患者接受肺楔形切除術。共60例(9.0%)患者發(fā)生術后并發(fā)癥,1例(0.2%)患者死亡。結(jié)論由經(jīng)驗豐富的醫(yī)生篩選的GGO病例,惡性病變比例高,可結(jié)合患者的病史資料、影像學資料、年齡、身體狀況和心理等情況決定是否行手術切除。手術以微創(chuàng)為主,行亞肺葉或肺葉切除,患者可獲得良好的治療效果。
[Abstract]:Objective to summarize and analyze the surgical diagnosis and treatment of ground-glass nodules (GGO) found by CT. Methods from January 2013 to December 2016, lung GGO patients who were treated by thoracic surgery in Huaxi Hospital of Sichuan University were retrospectively included. The clinical data before, during and after operation were summarized, and the characteristics of surgical diagnosis and treatment of GGO were analyzed. Results 663 cases were included, 614 cases were proved malignant after operation and pathology, the malignant ratio was 92.6%. The diameter of benign GGO was smaller than that of malignant GGO [(0.8 鹵0.2) cm vs. (1.5 鹵0.8) cm P0.001]. The incidence of borderline signs in malignant GGO group was higher than that in benign GGO group (93.8vs.20.4P0.001), but there was no significant difference in vacuole sign, pleural traction, prickles and lobular signs between the two groups (P0.05) .652 cases (98.3%) underwent thoracoscopic surgery. Only 11 cases (1.7%) underwent open surgery. 336 cases (50.7%) underwent lobectomy, 226 cases (34.1%) underwent segmental resection and 101 cases (15.2%) received wedge resection. A total of 60 (9. 0%) patients died of postoperative complications (0. 2%). Conclusion the GGO cases screened by experienced doctors have a high proportion of malignant lesions, which can be combined with the patient's history, imaging data, age, physical condition and psychology to decide whether or not to be excised. Minimally invasive surgery, subpulmonary lobectomy or lobectomy, patients can obtain good results.
【作者單位】： 四川大學華西醫(yī)院胸外科;四川大學華西醫(yī)院呼吸與危重癥醫(yī)學科;
【基金】：四川省衛(wèi)生和計劃生育委員會項目(No.16PJ292) 四川省科技廳科技支撐計劃項目(No.2014SZ0148,No.2016FZ0118)資助
【分類號】：R655.3

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