肺局灶性磨玻璃影（GGO）病变的诊疗体会

摘要

目的：探讨肺局灶性 GGO 的最佳治疗方式。方法：回顾性分析2007年1月至2013年12月我院收治的 CT 影像表现为肺局灶性 GGO 病变105例。对肺局灶性 GGO 的 CT 影像、手术的时机选择、手术方法、病理分型等数据进行分析。结果：接受手术治疗69例，其中局部肺切除21例，肺叶切除48例，15例发现淋巴结转移，其中混合型 GGO 14例，单纯型 GGO 1例。手术病例中恶性病变占74％（51／69）。36例未手术病例中，21例持续抗炎治疗至病变吸收、消散，最长3例治疗6周。6例未经继续抗炎或手术治疗，CT 随诊后病灶消失。6例病灶无变化继续随诊，3例病灶增大患者拒绝手术探查。手术病例随诊6个月至5年，无复发或转移。结论：单纯型 GGO 可行局部肺切除或肺叶切除，同时加淋巴结探查，混合型 GGO 需行肺叶切除加淋巴结清扫。%Objective:To study the best treatment of pulmonary focal GGO.Methods:To analyze the CT images, operation time,surgical treatment and pathological of 105 cases of pulmonary focal GGO from January 2007 to Decem-ber 2013.Results:Sixty nine cases accepted surgical treatment,21 cases accepted partial pneumonectomy,and 48 ca-ses accepted pneumonectomy among them.Among 15 cases with lymph node metastasis,14 cases were mix GGO and 1 case was pure GGO.Malignant lesions were 74% 69 cases(51 /69).Among 36 cases with no surgical treatment,21 cases were cured by anti -inflammatory therapy,there were 3 cases lasting six weeks.6 cases with no treatment.6 ca-ses with no change.3 cases became lager but they refused surgical treatment.Those cases recepted surgical treatment follow -up from six months to five years with no recurrence and transfer.Conclusion:Pure GGO can be cured by par-tial pneumonectomy or pneumonectomy with lymph node detection,mix GGO should be treated by pneumonectomy with lymph node cleaning.