CAJ | 학술논문

目的评价胸腔镜肺减容术治疗重度慢性阻塞性肺气肿(COPE)的临床疗效和应用价值.方法 2006年7月至2011年3月我院胸外科为12例重度COPE患者在胸腔镜下行肺减容术,比较患者手术前后肺功能指标的变化.结果全组术中顺利,无死亡,12例患者均康复出院,呼吸困难明显缓解.术后住院时间8 ～54 d,平均(16± 10)d.与术前比较,术后6、12个月第1秒用力呼气量、6 min步行距离均增加[第1秒用力呼气容积:(0.97 ±0.07)、(1.01±0.12)L比(0.68 ±0.15)L;6 min步行距离:(380±65)、(415±70)m比(225 ±70) m],肺总量及残气量均减少[肺总量:(6.3±1.1)、(6.1±1.2)L比(7.8±0.8)L;残气量:(3.6±0.6)、(3.3 ±0.5)L比(5.2±0.6)L],差异均有统计学意义(均P＜0.05).结论胸腔镜下肺减容术治疗重度COPE患者近期疗效确切,创伤小,肺功能恢复快,临床上实施切实可行.
목적 평개흉강경폐감용술치료중도만성조새성폐기종(COPE)적림상료효화응용개치.방법 2006년7월지2011년3월아원흉외과위12례중도COPE환자재흉강경하행폐감용술,비교환자수술전후폐공능지표적변화.결과 전조술중순리,무사망,12례환자균강복출원,호흡곤난명현완해.술후주원시간8 ～54 d,평균(16± 10)d.여술전비교,술후6、12개월제1초용력호기량、6 min보행거리균증가[제1초용력호기용적:(0.97 ±0.07)、(1.01±0.12)L비(0.68 ±0.15)L;6 min보행거리:(380±65)、(415±70)m비(225 ±70) m],폐총량급잔기량균감소[폐총량:(6.3±1.1)、(6.1±1.2)L비(7.8±0.8)L;잔기량:(3.6±0.6)、(3.3 ±0.5)L비(5.2±0.6)L],차이균유통계학의의(균P＜0.05).결론 흉강경하폐감용술치료중도COPE환자근기료효학절,창상소,폐공능회복쾌,림상상실시절실가행.
Objective To evaluate the efficacy and value of application of lung volume reduction surgery treating severe chronic obstructive pulmonary emphysema (COPE).Methods All 12 patients with COPE treated with lung volume reduction surgery (LVRS) were retrospectively analyzed.The lung function indexes of patients before LVRS,half a year and 1 year after LVRS were analyzed.Results All 12 patients recovered and were discharged from hospital.The time of hospitalization was 8-54 days [mean time:(16 ± 10) days].Compared to before operation,the forced expiratory volume in one second (FEV1),and 6-minute walk distance (6MWD) of patients with COPE were increased 6 months and 1 year after operation [FEV1:(0.97 ± 0.07),(1.01 ± 0.12) L vs (0.68 ±0.15)L;6MWD:(380 ±65),(415 ±70)m vs(225 ±70)m],and total lung capacity(TLC) and residualvolume (RV) significantly reduced [TLC:(6.3 ± 1.1),(6.1 ± 1.2) L vs (7.8 ± 0.8) L; RV:(3.6 ± 0.6),(3.3 ± 0.5) L vs (5.2 ± 0.6) L] (all P ＜ 0.05).Conclusions The lung volume reduction surgery is feasible,minimally invasive and provides rapid recovery of pulmonary function for severe COPE.