摘要
目的 探讨化疗对肺癌患者手术的影响 ,为合理的术前化疗提供依据。 方法 随机将 10 0例肺癌患者分为两组 ,术前化疗组 :5 9例 ,手术前先行化疗、再手术 ;术后化疗组 :41例 ,先行手术 ,术后化疗。绝大多数患者接受MVP方案化疗 ,1～ 6个周期。两组患者均行肺叶或一侧全肺切除术。术中观察两组患者胸内组织结构的变化 ,记录手术时间、术中失血量及术后第 1天引流量等。 结果 术前化疗组患者胸膜、肿瘤周围组织、淋巴结纤维化 ,以肺动脉外膜及其附近组织最明显 ,因而增加了手术风险和难度。术前化疗组手术时间、术中失血量和术后引流量与术后化疗组比较差别无显著性意义。 结论 化疗可增加肺癌患者的手术风险。术中细致的止血是减少术中、术后失血的主要措施 ,充足的化疗间隔、良好的术前准备和术后处理是减少术后并发症的关键。
Objective To investigate the effects of chemotherapy to patients' operation for lung cancer so as to provide evidence for rational preoperative chemotherapy. Methods One hundred patients were randomly divided into two groups . Preoperative chemotherapy group: 59 cases, the patients accepted chemotherapy at first, then underwent operation. Postoperative chemotherapy group : 41 cases, the patients accepted the chemotherapy after operation. Most of patients accepted the MVP chemotherapy regimen (1-6 course). All patients underwent operation of lobectomy or pneumonectomy. During the operation, the change of thoracic structure was observed. Some indexes, which include operation time, blood loss during operation and postoperative drainage volume in the first postoperative day were recorded. Results Thoracic tissue fibrosis which include pleura, the tissue around tumor and lymph nodes were observed in preoperative chemotherapy group. The tissue fibrosis around the pulmonary artery was most marked, which increased the risk and difficulty of operation. There was no significance in the operation time, the blood loss, and postoperative drainage volume in two groups. Conclusion Chemotherapy increases the patients' operative risks for lung cancer. Fibrosis is an underlying risk factor for blood loss, it is necessary to pay more attention on carefully hemostasis during the operation. To decrease the risks of postoperative complication, sufficient interval after chemotherapy, preoperative preparation and proper management after operation are the key factors.
出处
《中国胸心血管外科临床杂志》
CAS
2002年第3期182-184,共3页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
关键词
化疗
肺癌
手术
危险性
Chemotherapy
Lung cancer
Operation
