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目的 :总结电视腔镜术治疗高龄肺癌患者的经验。方法 :回顾性分析 2 2例高龄肺癌患者 (年龄≥ 70岁 )的临床资料。结果 :肺叶部分切除 4例 ,肺叶切除 1 4例 ,全肺切除 1例 ,术中转开胸 1例 ,剖胸探查 2例。出血 50～ 80 0ml,平均 30 5ml,手术时间 40～ 2 4 5min。术后 4例并发肺不张 ;4例出现多源性房性早搏 ;1例因痰稠、咳嗽无力行纤支镜下吸痰 ;4例胸腔积液 ,需作胸穿 ;3例病人需要输血 (占 1 3 .6 % ) ,分别为 40 0ml,40 0ml和 80 0ml;胸管停留时间 3～ 5d ;1例于术后第 1 1天死于呼吸衰竭。随访患者 1 4例 ,随访率为 63 .6 % ,随访时间 1～ 5年。 1年内生存率 78.5 % (1 1 / 1 4 ) ,3年生存率 42 .8% (6/ 1 4 ) ,5年 2 8.5 % (4/ 1 4 )。结论 :VATS ,切口小 ,损伤小 ,出血少 ,不输血或少输血、伤口愈合快 ,并发症少 ,病人痛苦少 ,对肺功能影响小。以其优点应用到高龄肺癌患者疗效满意。为提高高龄肺癌患者的手术成功率 ,必须严格掌握手术指征 ,术中尽量保留余肺 ;尽量避免作全肺切除
OBJECTIVE: To summarize the experience of video-assisted endoscopy in the treatment of elderly patients with lung cancer. Methods: A retrospective analysis of 22 cases of elderly patients with lung cancer (age ≥ 70 years) clinical data. Results: Partial lung resection in 4 cases, lobectomy in 14 cases, pneumonectomy in 1 case, intraoperative thrombolysis in 1 case and thoracotomy in 2 cases. Bleeding 50 ~ 80 0ml, an average of 30 5ml, operation time 40 ~ 2455min. 4 cases had atelectasis atrial fibrillation in 4 cases, multi-source atrial premature beats in 4 cases, 1 case of sputum thickening due to thick phlegm and coughing, 3 cases of pleural effusion requiring pleural effusion Blood transfusion (13.6%) was 40 0ml, 40 0ml and 80 0ml, respectively. The duration of chest tube was 3 to 5 days. One patient died of respiratory failure on the first day after operation. Follow-up patients were 14 cases, the follow-up rate was 63.6%, follow-up time of 1 to 5 years. The 1-year survival rate was 78.5% (1 1/14), 3-year survival rate was 42.8% (6/1 4), and 5 years 2 8.5% (4/14). Conclusion: VATS has the advantages of small incision, less injury, less bleeding, no blood transfusion or less blood transfusion, faster wound healing, fewer complications, less pain and little impact on pulmonary function. With its advantages applied to elderly patients with lung cancer satisfaction. To improve the success rate of elderly patients with lung cancer surgery, surgical indications must be strictly controlled, as far as possible to retain excess lung surgery; try to avoid making pneumonectomy