肺癌合并冠状动脉疾病的手术疗效分析

S. Gerasimov, M. V. Serebryanskaya, M. Davydov, R. Akchurin, Y. Buziashvili, E. Golubev, E. Charchyan, D. V. Puzenko, P. Kononets
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摘要

结果:术后并发症发生率33.8%(22/65),病死率3.1% (2/65);采用分阶段战术,这些数字分别为31.7%(19/60)和3.3% (2/60);同时操作后- 60%(3/5)和0%。肺癌患者在初步心肌血运重建术后行手术时,术后心肌梗死发生率为3.3%(2/63),死亡率为1.6%(1/63)。长期来看,根治性手术患者的1、3、5年总生存率分别为:I期为95,7%、86,3%、64,7%,II期为82,6%、62,4%、49,9%,III期为66,0%、55,8%和34,3% (p = 0,042)。结论:对肺癌合并重症冠状动脉疾病患者实施预防性心肌血运重建术,可扩大根治患者群体,取得满意的近期和远期治疗效果。关键词:肺癌,冠状动脉疾病,肺叶切除术,胆管切除术,全肺切除术,冠状动脉搭桥手术,冠状动脉成形术
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SURGICAL RESULTS OF LUNG CANCER TREATMENT IT PATIENTS WITH CONCOMITANT CORONARY ARTERY DISEAS
Results: the incidence of postoperative complications was 33,8% (22/65), mortality – 3,1% (2/65); with phased tactics, these figures were 31,7% (19/60) and 3,3% (2/60); after simultaneous operations – 60% (3/5) and 0%, respectively. When performing operations for lung cancer after preliminary myocardial revascularization, the incidence of postoperative myocardial infarction was 3,3% (2/63), with a fatal outcome of 1,6% (1/63). In the long term, the total 1-, 3- and 5-year survival rate of radically operated patients was: at stage I – 95,7%, 86,3%, 64,7%, with II – 82,6%, 62,4%, 49,9% and at III – 66,0%, 55,8% and 34,3%, respectively (p = 0,042). Conclusions: the implementation of prophylactic myocardial revascularization in patients with lung cancer with severe forms of concomitant coronary artery disease allows to expand the group of radically operated patients, to achieve satisfactory immediate and long-term treatment results. Key words: lung cancer, coronary artery disease, lobectomy, bilobectomy, pneumonectomy, coronary artery bypass surgery, coronary angioplasty
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