肺局灶性磨玻璃影(GGO)病变的诊疗体会

目的:探讨肺局灶性GGO的最佳治疗方式。方法:回顾性分析2007年1月至2013年12月我院收治的CT影像表现为肺局灶性GGO病变105例。对肺局灶性GGO的CT影像、手术的时机选择、手术方法、病理分型等数据进行分析。结果:接受手术治疗69例，其中局部肺切除21例，肺叶切除48例，15例发现淋巴结转移，其中混合型GGO 14例，单纯型GGO 1例。手术病例中恶性病变占74％(51／69)。36例未手术病例中，21例持续抗炎治疗至病变吸收、消散，最长3例治疗6周。6例未经继续抗炎或手术治疗，CT随诊后病灶消失。6例病灶无变化继续随诊，3例病灶增大患者拒绝手术探查。手术病例随诊6个月至5年，无复发或转移。结论:单纯型GGO可行局部肺切除或肺叶切除，同时加淋巴结探查，混合型GGO需行肺叶切除加淋巴结清扫。

Experience in the treatment and diagnosis of pulmonary focal ground -glass opacity (GGO)

Objective:To study the best treatment of pulmonary focal GGO.Methods:To analyze the CT images,operation time,surgical treatment and pathological of 105 cases of pulmonary focal GGO from January 2007 to December 2013.Results:Sixty nine cases accepted surgical treatment,21 cases accepted partial pneumonectomy,and 48 cases accepted pneumonectomy among them.Among 15 cases with lymph node metastasis,14 cases were mix GGO and 1 case was pure GGO.Malignant lesions were 74% 69 cases(51/69).Among 36 cases with no surgical treatment,21 cases were cured by anti-inflammatory therapy,there were 3 cases lasting six weeks.6 cases with no treatment.6 cases with no change.3 cases became lager but they refused surgical treatment.Those cases recepted surgical treatment follow-up from six months to five years with no recurrence and transfer.Conclusion:Pure GGO can be cured by partial pneumonectomy or pneumonectomy with lymph node detection,mix GGO should be treated by pneumonectomy with lymph node cleaning.