CAJ | 학술논문

目的初步探讨大型C臂机实时引导下经超细支气管镜肺大疱减容术的有效性及其影响因素.方法 6例肺大疱患者均在大型C臂机实时引导下经超细支气管镜工作通道先后通过微导管向目标细支气管注入利多卡因、自身血、纤维蛋白原、凝血酶.通过患者客观症状、肺功能FEV1、胸部HRCT、血气分析、6分钟步行距离等指标评价术式的有效性及其影响因素.结果 6例患者中,术后完全有效2例,明显有效1例,基本有效2例,完全无效1例(有效率83.3％).有效性影响因素可能包括肺大疱周围肺组织对所注入的减容药物反应程度、H RCT扫描肺大疱大小时呼吸动度、肺大疱周围组织内源性弹性回缩作用力大小及其各个作用力的方向、患者特异质等.结论应用大型C臂机实时引导下经超细支气管镜肺大疱减容术,可以避免手术治疗并发症的发生,缩短住院时间,改善肺功能,提高患者生活状态,值得进一步推广.
목적 초보탐토대형C비궤실시인도하경초세지기관경폐대포감용술적유효성급기영향인소.방법 6례폐대포환자균재대형C비궤실시인도하경초세지기관경공작통도선후통과미도관향목표세지기관주입리다잡인、자신혈、섬유단백원、응혈매.통과환자객관증상、폐공능FEV1、흉부HRCT、혈기분석、6분종보행거리등지표평개술식적유효성급기영향인소.결과 6례환자중,술후완전유효2례,명현유효1례,기본유효2례,완전무효1례(유효솔83.3％).유효성영향인소가능포괄폐대포주위폐조직대소주입적감용약물반응정도、H RCT소묘폐대포대소시호흡동도、폐대포주위조직내원성탄성회축작용력대소급기각개작용력적방향、환자특이질등.결론 응용대형C비궤실시인도하경초세지기관경폐대포감용술,가이피면수술치료병발증적발생,축단주원시간,개선폐공능,제고환자생활상태,치득진일보추엄.
Objective Pilot study of the effectiveness and impact factors of weensy bronchoscope bullae volume reduction surgery with real time guide by large C-arm.Methods Six cases of patients with bullae had been orderly injected lidocaine, own whole blood, fibrinogen, thrombin in the target bronchioles through working channel of ultrafine bronchoscope with real time guide by large C-arm.The effectiveness and its impact factors of the present surgery were evaluated on the basis of indexes,such as symptoms,FEV1 of lung function,HRCT of chest,blood gas analysis,and walking distance in six minutes.Results Within the six patients,after the surgery,two were showing completely effective,one was showing obviously effective,two were showing fundamentally effective,and one was showing ineffective (the effective rate reached 83.3％ ).The impact factors of effectiveness may include the extent of reaction of lung tissues around the bullae of the injected drugs for reduce volume,during the HRCT scans of the size the bullae,the activate degree of breathe,endogenous elastic retraction acting force,direction of other acting forces,the diathesis of patients,and so on.Conclusions Apply the weensy bronchoscope bullae volume reduction surgery with real time guide by large C-arm could avoid the incidence of complications after surgery,shorten hospital stays,improve lung function,cnhancc live state of patients.It is worth to popularize in clinic.