目的 总结同期肺叶切除联合心脏手术治疗肺部疾病合并心脏病患者的临床经验。 方法 回顾性分析2003 年2 月至2009 年9 月同济大学附属东方医院8 例肺部疾病合并心脏病患者同期行肺叶切除联合心脏手术治疗的临床资料, 其中男4 例,女4 例;年龄(65±3)岁。行左肺上叶切除术1 例、左肺下叶切除术2 例, 右肺上叶切除术2 例、右肺上、中叶切除术1 例、右肺下叶切除术2 例;主动脉瓣置换术2 例,左心房部分切除术1 例,冠状动脉旁路移植术5 例。 结果 无围术期死亡,术后发生心房颤动1 例,经药物治疗复律成功;发生一过性神经系统功能障碍1 例。术后病理诊断:鳞癌4 例,腺癌2 例,错构瘤1 例,肉芽肿1 例。随访8 例,随访时间6 ~ 48 个月。随访期间未发现局部或远处转移征象,未出现心绞痛复发、心肌梗死、血栓和心律失常,心功能分级(NYHA)Ⅰ~Ⅱ级。 结论 在选择患者的条件下,同期施行肺叶切除联合心脏手术治疗肺部疾病合并心脏病患者,是一种安全、有效的治疗方法。
Citation:
汪进益,陈国涵,洪暄等. 同期肺叶切除联合心脏手术的临床应用. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2012, 19(1): 93-94. doi:
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- 1. Prokakis C, Koletsis E, Apostolakis E, et al. Combined heart surgery and lung tumor resection. Med Sci Monit, 2008, 14(3):17-21.
- 2. Schoenmakers MC, van Boven WJ, van den Bosch J, et al. Comparison of on-pump or off-pump coronary artery revascularization with lung resection . Ann Thorac Surg, 2007, 84(2):504-509.
- 3. Wu L, Xu Z, Zhao X, et al. Surgical treatment of lung cancer invading the left atrium or base of the pulmonary vein. World J Surg, 2009, 33(3):492-496.
- 4. 闵家新, 肖颖彬, 张国强, 等. 体外循环在胸部肿瘤手术中的应用价值. 中国胸心血管外科临床杂志, 2008, 15(6):470-472.
- 5. Dyszkiewicz W, Jemielity M, Piwkowski C, et al. The early and late results of combined off-pump coronary artery bypass grafting and pulmonary resection in patients with concomitant lung cancer and unstable coronary heart disease. Eur J Cardiothorac Surg, 2008, 34(3):531-535.
- 6. 彭丽君, 乔贵宾, 曾伟生. 体外循环在局部晚期胸部恶性肿瘤外科治疗中的应用进展. 中国胸心血管外科临床杂志, 2007, 14 (3):221-224.
- 7. Patanè F, Verzini A, Zingarelli E, et al. Simultaneous operation for cardiac disease and lung cancer. Interact Cardiovasc Thorac Surg, 2002, 1(2):69-71.