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目的探讨高龄肺癌患者外科治疗的临床价值并总结围术期处理的经验。方法回顾性分析自2005年7月—2009年8月间在河南省肿瘤医院胸外科接受手术治疗的70岁以上肺癌患者42例的临床资料。结果42例均在气管插管、静脉复合麻醉下接受全肺切除、肺叶切除,肺叶加支气管成形术等术式的手术治疗,术后早期死亡1例。随访率92.9%。术后1、3、5年生存率分别为81.0%(34/42)、40.5%(17/42)、28.6%(12/42)。结论手术治疗仍是高龄肺癌的有效治疗手段,肿瘤分期及心肺功能状况是决定能否手术的依据。重视围术期处理及选择合适的手术方式是外科治疗成功的关键。
Objective To investigate the clinical value of surgical treatment of elderly patients with lung cancer and summarize the experience of perioperative management. Methods The clinical data of 42 patients with lung cancer over the age of 70 who were surgically treated in Department of Thoracic Surgery, Henan Tumor Hospital from July 2005 to August 2009 were retrospectively analyzed. Results All the 42 cases underwent pneumonectomy, lobectomy and lobectomy combined with bronchoplasty were performed under endotracheal intubation and intravenous anesthesia. One patient died early after operation. The follow-up rate was 92.9%. The 1, 3, 5 year survival rates were 81.0% (34/42), 40.5% (17/42) and 28.6% (12/42) respectively. Conclusion Surgical treatment is still an effective treatment for advanced lung cancer. The staging of tumor and cardiopulmonary function are the basis for determining whether surgery is possible or not. Emphasis on perioperative management and selection of appropriate surgical approach is the key to the success of surgical treatment.