用自体肺移植技术治疗Ⅲ期中心型肺癌

摘要

目的探讨应用自体肺移植技术治疗Ⅲ期中心型肺癌的可行性。方法下肺离体后置于肝素溶液中，10分钟后将下肺静脉吻合于上叶静脉残端，再行支气管吻合和肺动脉吻合。静脉、支气管、动脉吻合分别耗时14、13、11分钟，肺动脉阻断时间2.5小时。结果术后3天拔胸管，肺膨胀良好，术后5天患者能下地活动。术后1 个月CT增强扫描显示重植肺血液灌注和回流良好。纤维支气管镜检查吻合口通畅。结论对于心肺功能不能耐受全肺切除的Ⅲ期中心型肺癌病人，可以考虑应用自体肺移植技术。自体肺移植是一种能保全肺组织的肺癌根治术式。%Objective　To assess the a ppli cability of lung autotransplantation tec hnique in the treatment of stage Ⅲ centr al lung cancer．Method　The “cutdo wn” lowe r lobe was immersed in heparin solution for 10 minutes．It took 14，13 and 11 minu tes to finish the anastomois of pulomona ry vein，bronchus，and artery．The pulmonar y artery was blocked for 2.5 hours．R esul t　On the 3rd day after operation，the che st tube was retreated with the reimplate d lung inflating well．On 5th day，the pat ient could walk around．The reconstructio n of pulmonary vessles and airway were p roved satisfactory in function by CT and brouchofiberscopy one month after opera tion．Conclusion　Lung autotranspl antation is an alternative technique with pulmon ary preservation for patients with stage Ⅲ central lung cancer of upper lobe whe n his pulmonary reserve is too low to af ford pneumonectomy．