体外循环在局部晚期肺恶性肿瘤切除手术中的应用体会

摘要

背景与目的 体外循环(cardiopulmonary bypass,CPB)应用于侵犯心脏及大血管的肺局部晚期恶性肿瘤切除手术开展较少.本研究回顾分析我院近年来完成的CPB辅助下肺局部晚期恶性肿瘤切除手术.总结CPB的应用管理体会.方法 CPB辅助下完成肺局部晚期恶性肿瘤切除手术4例,临床分期均为T4NOMO,非CPB下均无法根治性切除.4例均采用浅低温体外循环方法,转流时间为79min-155min,心脏停跳时间57min-126min.结果 本组无术中死亡.CPB转流平稳,均自动复跳.4例停机顺利.全组均顺利出院,1例术后13个月因心衰死亡,1例术后22个月死于肿瘤远处转移.1例术后19个月、1例术后5个月仍存活.结论 CPB有助于帮助外科医生对局部晚期肺肿瘤施行完全性肺癌切除.%Background and objective Cardiopulmonary bypass (CPB) in the treatment of locally advanced pulmonary malignant tumors invaded heart or great vessels was not well underwent, The aim of this study is to report the results of these cases with locally advanced pulmonary malignant tumor which were completely resected under CPB in our hospital.Methods Four patients with locally advanced pulmonary malignant tumors were operated under CPB. All patients had stage Ⅲb disease (T4N0M0). Moderate hypothermia CPB was used for all 4 cases. The CPB time was 79 min-155 min and aortic cross-clamp time was 57 min-126 min, respectively. Results There was no operative death in this series, CPB was smooth, and heart automatically rebeated in the 4 patients. All the 4 patients were discharged in 3 weeks. One patient dead of heart failure at 13 months after operation, one case dead of distant tumor metastasis at 22 months after operation. The other two patients have survived over 25 months and 11 months, respectively. Conclusion CPB is helpful for completely removal of locally advanced pulmonary malignant tumors.