胸膜切除术

Movement of the diaphragm recovered.Conclusion:When more pulmonary tissue needs to be resected,segmental bronchial extirpation and diaphragm upward displacement shou ld be used to prevent residual pleural cavity and movement of mediastinum,to rel ease overexpansion of pulmonary tissue and to preserve more pulmonary function.

支气管扩张症需切除较多肺组织时，应合并采用肺段支气管剔除术和膈肌上移术，以达到防止胸膜残腔，减轻纵隔移位，减轻肺过度膨胀和最大限度保护肺功能的目的。

Pleurectomy, partial pericardiectomy, partial rib resection, lymph node resection and phrenectomy were simultaneously performed in 42 cases. Systemic chemotherapy was administered in five patients before operation.

同时行胸膜剥除、心包部分切除、部分上腔静脉切除再吻合、部分肋骨切除、纵隔淋巴结及锁骨上淋巴结清除或隔肌部分切除42例，有5例术前行化疗1个疗程。

Expansion of the pleural pneumonectomy operative mortality of 10% to 25%, but the effect is no less than pleural resection, is not recommended wider use.

扩大性胸膜肺切除术的手术死亡率为10%～25%，但疗效并不比胸膜切除术好，故不建议广泛应用。

Mediastinoscopy, however, seems to have a limited role in patient selection for extrapleural pneumonectomy.

而纵隔镜检查对于选择胸膜外全肺切除术的病人仅仅有着有限的作用。

OBJECTIVES: Extrapleural pneumonectomy is a therapeutic option for selected patients with malignant pleural mesothelioma.

目的：胸膜外全肺切除术是部分恶性胸膜间皮瘤病人的一种治疗方法。

Radical surgical treatment such as Extrapleural pneumonectomy, applies only to a very small number of cases limited lesions.

根治性外科治疗如胸膜外肺切除术，仅适用于极少数病变局限的病例。

Radical surgery with extrapleural pneumonectomy and adjuvant treatments has become the preferred option in early disease, but the benefits of such an aggressive approach have been questioned because of significant treatment-related morbidity and mortality.

因此，多学科综合治疗得以发展，联合胸膜外肺切除术和辅助治疗的根治性手术成为早期病例的首选，但该法损伤性大且疗效因与该治疗相关的发病率和死亡率明显升高而饱受质疑。

（1）Bullae of lung ruptured spontaneous pneumothorax is the best indication for VATS,which has the advantages of less trauma and ache,short operation time,quick recovery and small incision;（2）Recurrent unilateral spontaneous pneumothorax with contineous air leakage of 7 days after closed thoracic drainage,bilateral spontaneous pneumothorax should be treated by VATS;（3）Spontaneous pneumothorax with pleura adhesion can be treated by pneumonolysis and bullae of lung excision under thoracoscopy assisted small incision operation.

疗效满意。结论：（1）肺大泡破裂自发性气胸是胸腔镜手术最佳的适应证，与传统开胸手术相比，胸腔镜手术具有患者创伤小，手术时间短，术后疼痛轻，康复快，符合美容要求等特点；（2）反复发作的单侧自发性气胸，行胸腔闭式引流术后持续漏气7d，双侧自发性气胸，不论是否同时发作都可考虑胸腔镜手术治疗；（3）自发性气胸并胸膜粘连可用胸腔镜辅助小切口行粘连松解肺大泡切除术；（4）为减少一次性材料的消耗，降低手术成本，可辅助小切口使用常规胸科手术器械完成手术；（5）为减少术后复发率需行胸膜固定术。

There were spontaneous pneumochorax 103 cases, lung biopsy 3 cases, pulmonary wedge resection 30 cases, pulmonary lobectomy 4 cases; hydrothorax 9 cases, pleural lesion 2 cases; mediastinum lesion 17 caese, mediastinum lymph node biopsy 3 cases, repair of pulmonary I case, repair of diaphragm 1 case.

方法173例手术中包括自发性气胸103例，肺活检3例，肺楔形切除术30例，肺叶切除4例，胸腔积液9例，胸膜病变2例，纵隔占位17例，纵隔淋巴结活检3例，外伤肺修补术1例，膈肌修补1例。

For a big chunk of credit-card losses; the number of filings (and thus charge-off rates) would be rising again, whether

年美国个人破产法的一个改动使得破产登记急速下降，而后引起了信用卡大规模的亏损。

Eph. 4:23 And that you be renewed in the spirit of your mind

弗四23 而在你们心思的灵里得以更新