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肺隔离高温药物灌注治疗肺癌(附14例报告)

Isolated Hyperthermic Lung Perfusion with Chemotherapeutic Agents in the Treatment of Unresectable Lung Cancer

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【作者】 蒲斌刘洪林耿益文李书用叶广华周忠岭

【Author】 Pu Bin,Liu Honglin,Geng Yiwen,et al.Department of Cardiothoracic Surgery,Zaozhuang City Hospital,Shandong 277102

【机构】 山东枣庄市立医院胸心外科

【摘要】 游离阻断14例中、晚期肺癌病人的单侧肺(或肺叶)主要血管,经肺动脉、肺静脉插管与心泵连接,建立与体循环隔离的体外肺循环。在肝素化预充液中加入超量表阿霉素和环磷酰胺,进行高温(41~43℃)灌注50~60分钟,停机关胸。本组无手术死亡。术后1、2年分别死亡2、5例,生存率分别为85.7%和50%,余7例均健在。术后10~12个月对肺部残存肿块在CT定向下穿刺活检均为纤维组织。证明此疗法杀灭肿瘤组织效果确切,对正常肺组织的损伤是轻微且可逆的

【Abstract】 Aim:To review the experience of isolated hyperthermic lung perfusion with chemotherapeutic agents in the treatment of unresectable lung cancer.Clinical material and method:14 patients with late stage lung cancer underwent isolated hyperthermic lung perfusion with chemotherapeutic agents.A perfusion catheter was inserted in the pulmonary artery,a venous drainage cannula was placed in the pulmonary vein,and both catheters were connected to the heart pump.The lung or lobe was totally isolated and then perfused with adriamycin(7~8μg/ml)and cyclophosphamide(0.2~0.3mg/ml)under hyperthermia of 41~42℃ for 50~60 minutes.Result:There were no hospital deaths.The complications included hypovolemic shock and acute pulmonary edema.The mean hospital stay was 11.5 days(range,9~13 days).During follow up of 18 to 26 months,one patient developed bone metastases.The 1 year and 2 year survival rates were 85.3% and 50%,respectively.After treatment,complete improvement was achieved in 3 patients and partial improvement in 11 patients.Conclusion:Isolated hyperthermic lung perfusion with chemotherapeutic agents is a safe and effective method for the treatment of late lung cancers,particularly for those unresectable tumors.Injuries to the hyperthermically perfused lungs was slight and reversible.

  • 【文献出处】 中华胸心血管外科杂志 ,CHINESE JOURNAL OF THORACIC AND CARDIOVAESCULAR SURGERY , 编辑部邮箱 ,1998年05期
  • 【分类号】R734.2
  • 【被引频次】9
  • 【下载频次】30
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