Neviere Rémi, Catto Michèle, Bautin Nathalie, Robin Sophie, Porte Henri, Desbordes Jacques, Matran Régis
Explorations Fonctionnelles Respiratoires, Hôpital Calmette, CRHU Lille, France.
J Thorac Cardiovasc Surg. 2006 Nov;132(5):1203-7. doi: 10.1016/j.jtcvs.2006.08.002.
Although resection of giant bullae for the purpose of improving the function of underlying compressed lung is an accepted form of surgery for emphysema, there is only limited information regarding long-term improvement in dynamic hyperinflation and exercise tolerance. Our major goal was to investigate the effects of lung resection for giant bullae on pulmonary function, dynamic hyperinflation, and exercise capacity in patients with chronic obstructive pulmonary disease characterized by emphysema.
Pulmonary function and exercise testing were assessed prospectively before and 3, 6, 12, 24, and 48 months after surgery in 12 patients who had chronic obstructive pulmonary disease with emphysema who underwent lung resection of giant bullae.
Forced expiratory volume, diffusing capacity for carbon monoxide, arterial partial pressure of oxygen, and exercise capacity were significantly increased after resection of surgical bullae. Dynamic hyperinflation, as assessed by reduction in inspiratory capacity and dyspnea Borg scale, were significantly decreased during exercise. Improvement in baseline and exercise functional capacity slightly decreased over time, remaining, however, far above the value before surgery.
Altogether, these findings suggest that surgery for resection of giant bullae is an effective procedure for improving airflow, limiting gas exchange, and limiting exercise dynamic hyperinflation over time.
尽管为改善受压肺组织功能而切除巨大肺大疱是一种被认可的肺气肿手术方式，但关于动态肺过度充气和运动耐力的长期改善情况的信息有限。我们的主要目标是研究切除巨大肺大疱的肺切除术对以肺气肿为特征的慢性阻塞性肺疾病患者的肺功能、动态肺过度充气和运动能力的影响。
对12例患有肺气肿的慢性阻塞性肺疾病且接受了巨大肺大疱肺切除术的患者，在手术前以及术后3、6、12、24和48个月进行前瞻性肺功能和运动测试评估。
切除手术性肺大疱后，用力呼气量、一氧化碳弥散量、动脉血氧分压和运动能力显著增加。通过吸气量减少和呼吸困难Borg量表评估的动态肺过度充气在运动期间显著降低。基线和运动功能能力的改善随时间略有下降，但仍远高于手术前的值。
总体而言，这些发现表明，切除巨大肺大疱的手术是一种有效的方法，可随着时间的推移改善气流、限制气体交换并限制运动动态肺过度充气。
