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新辅助化疗对ⅢA期非小细胞肺癌手术安全性的影响

THE EFFECT OF NEOADJUVANT CHEOTHERAPY ON SAFETY OF OPERATION IN PATIENTS WITH ⅢA NON SMALL CELL LUNG CANCER

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【作者】 王思愚吴一龙黄植藩区伟杨学宁余辉

【Author】 WANG Si yu, WU Yi long,HUANG Zhi fen, . Lung Cancer Reseach Center,SUN Yat Sen University of Medical Sciences,Guangzhou 510060,China

【机构】 中山医科大学肺癌研究中心!广州510060

【摘要】 目的 探讨新辅助化疗对手术安全性的影响。方法  1995年 1月~ 1999年 12月 ,对 5 0例 A NSCL C患者行辅助化疗 ,选择同期行单纯手术 A NSCL C患者作为对照 ,所有病例均行肺叶或全肺切除术加纵隔淋巴结清扫术 ,以肺感染、需行药物治疗心律失常、支气管残端瘘、气管切开发生率、肺不张发生率作为手术合并症的观察指标 ,比较两组病例手术期合并症和死亡。结果 新辅助化疗组术后心律失常发生率明显多于对照组 (2 4% :6 % ,P<0 .0 5 ) ,而肺感染、支气管残端瘘、气管切开、肺不张发生率两组无差别 ,新辅助化疗组中有 2例术后死亡。结论 新辅助化学在一定程度增加手术的合并症和死亡 ,应给予重视 ,并采取积极预防措施

【Abstract】 Objective To study the effect of neoadjuvant chemotherapy on safety of operation in patients with non small cell lung cancers.Methods Between Jan. 1995 and Dec.1999,a group of 50 patients with ⅢA NSCLC undergoing lobectomy or pneumonectomy with mediastinal lymphadenectomy after a neoadjuvant chemotherapy were compared to patients operated but without preoperative chemotherapy. Complications including the incidence of pneumonia,cardiac arymth,bronchio pleura fistula,tracheostomy, and atelectasis were analyzed. The operative mobility and mortality were compared between two groups. Results The incidence of cardiac arymth after operation was higher than the other group (24% vs 6%, P <0.05). No differences in incidence of pneumonia, bronchio pleural fistula,tracheostomy, and atelectasis between the two groups. There are two patients died after operation in the group receiving new chemotherapy.Conclusion Noeadjuvant chemotherapy increased the perioperative complications and mortality in some degree. Measures to prevent these effects should be seriously considered before the use of the new adjuvant chemotherapy.

  • 【分类号】R734.2
  • 【被引频次】29
  • 【下载频次】112
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