单侧胸腔镜下肺减容术治疗老年性大疱型肺气肿

发布时间：2018-03-18 03:22

本文选题：慢性阻塞性肺疾病　切入点：胸腔镜手术　出处：《中国现代医学杂志》2017年16期 　论文类型：期刊论文

【摘要】：目的探讨单侧胸腔镜下行肺减容术(LVRS)治疗老年性慢性阻塞性肺疾病(COPD)的方法及疗效。方法经严格掌控手术适应证,30例重度大疱型肺气肿的患者被纳入手术,术中应用腔镜用切割缝合器(Endo GIA)切除无功能肺组织,切除部分占肺容积的20%~30%。对比术前、术后3、6和12个月的肺功能、血气及6 min步行试验等监测指标。结果 30例患者无死亡病例,术后随访肺功能、血气指标改善,呼吸困难症状减轻,活动耐力不同程度增加。术后3、6和12个月比较第1秒用力呼气量(FEV1)、最大肺活量(FVC)、肺残气量(RV),差异有统计学意义,术后3个月血氧分压(PO_2)、6 min步行实验(6MWT)与术后12月比较差异有统计学意义。结论胸腔镜下行肺减容术对于大疱型肺气肿是一种有效的治疗方法,可改善患者术后活动能力,提高患者生活质量,近期手术效果明显,随着时间延长手术效果有减退趋势。
[Abstract]:Objective to investigate the method and effect of unilateral thoracoscopic pulmonary volume reduction (LVRSs) in the treatment of senile chronic obstructive pulmonary disease (COPD). Methods 30 patients with severe bullous emphysema were included in the operation. Endoscopy was used to remove nonfunctional lung tissue with Endo GIA. The lung function was compared before and after 3 months and 12 months after operation, and 20% of the lung volume was removed. Results there were no death cases in 30 patients. Pulmonary function, blood gas index and dyspnea symptoms were improved after operation, and the symptoms of dyspnea were alleviated. The activity endurance was increased in different degree. There were significant differences in FEV1, FVCV, RV and RV between 3 months after operation and 12 months after operation, compared with the 1 seconds forced expiratory volume (FEV1), the maximal vital capacity (VV) and the lung residual volume (RV), the difference was statistically significant. Three months after operation, there was a significant difference between the 6 MWTs and the 6 MWTs. Conclusion the thoracoscopic pulmonary volume reduction is an effective method for the treatment of bullous emphysema, and it can improve the postoperative activity of the patients. To improve the quality of life of patients, the effect of operation is obvious in the near future, and the effect of operation has a tendency to decrease with the prolongation of time.
【作者单位】：海南省第三人民医院心胸外科;
【分类号】：R655

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