摘要
目的:探讨肺减容手术治疗重度慢性阻塞性肺气肿的疗效。方法:本组肺减容手术23例,其中经后外侧切口单侧肺减容18例,经胸骨正中切口双侧肺减容5例。根据术前CT所显示的靶区,用直线切割缝合器切除病变,术前、术后查肺功能、动脉血气分析,进行对比。结果:本组无手术死亡,患者动脉血氧分压术后比术前明显提高(P<0.05),二氧化碳分压术后比术前明显降低(P<0.05);术后FEV1比术前有明显改善(P<0.05),RV、TCL较术前有明显降低(P<0.05);呼吸困难指数再分级,18例术前Ⅲ级中6例转为Ⅰ级,12例转为Ⅱ级;5例Ⅳ级中1例转为Ⅰ级,3例转为Ⅱ级,1例转为Ⅲ级。结论:重度肺气肿病人选择性手术,能改善患者肺功能,提高生活质量,长期效果有待进一步观察。
Objective:To evaluate the efect of lung volume reduction surgery(LVRS)for treatment of severe chronic obstructive emphysema.Methods:The LVRS was performed in 23 patients,among which,18 unilateral LVRS and 5 simultaneously bilateral LVRS.The selection of incision depended on the target location of emphysema and was determined by computed tomography scan.A linear stapling device was used to excise the most emphysematous portion of lung.The results of lung function(FEV 1,RV,TLC)and arterial blood gas analysis(PaO 2,PaCO 2)were done before and 3 and 6 months after LVRS.Results:There was no perioperative death in this group.The FEV 1,RV,TLC were improved significantly after surgery(P<0.05)。PaO 2 increased(P<0.05)and PaCO 2 decreased postoperatively(P<0.05).For dyspnea scale,among 18 patients with a preoperative grade of Ⅲ,6 patients improved to grade Ⅰ,and 12 improved to grade Ⅱ;among the 5 patients with a preoperative grade of Ⅳ,1 patient improved to grade Ⅰ,3 patients improved to grade Ⅱ;and 1 patient improved to grade Ⅲ.Conclusions:LVRS can improve the respiratory function and quality of life in selected patients with severe emphysema,but the long term results was not clear yet.
出处
《华西医学》
CAS
2005年第2期218-219,共2页
West China Medical Journal
关键词
肺减容手术
重度肺气肿
肺功能
呼吸系统
lung volume reduction surgery
severe emphysema
pulmonary function
