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肺减容手术对慢性阻塞性肺疾病患者肺功能的中期影响。

Mid-term effects of lung volume reduction surgery on pulmonary function in patients with chronic obstructive pulmonary disease.

作者信息

Liu Jin-Ming, Yang Wen-Lan, Jiang Ge-Ning, Ding Jia-An, Zheng Wei, Liu Wen-Zeng, Wang Ying-Min, Gao Bei-Lan, Jiang Ping, Wu Wen, Li Xia, Bjorn Jonson

机构信息

Department of Respiratory Medicine, Pulmonary Function Test Laboratory and Department of Thoracic Surgery, Shanghai Pneumology Hospital, Tongji University, Shanghai, China.

出版信息

Chin Med J (Engl). 2007 Apr 20;120(8):658-62.

Abstract

BACKGROUND

Now lung volume reduction surgery (LVRS) has become one of the most effective methods for the management of some cases of severe chronic obstructive pulmonary disease (COPD). We evaluated the mid-term effects of LVRS on pulmonary function in patients with severe COPD.

METHODS

Ten male patients with severe COPD aged 38 - 70 years underwent LVRS and their pulmonary function was assessed before, 3 months and 3 years after surgery. The spirometric and gas exchange parameters included residual volume, total lung capacity, inspiratory capacity, forced vital capacity, forced expiratory volume in one second, diffusion capacity for CO, and arterial blood gas. A 6-minute walk distance (6MWD) test was performed.

RESULTS

As to preoperative assessment, most spirometric parameters and 6MWD were significantly improved after 3 months and slightly 3 years after LVRS. Gas exchange parameters were significantly improved 3 months after surgery, but returned to the preoperative levels after 3 years.

CONCLUSIONS

LVRS may significantly improve pulmonary function in patients with severe COPD indicating for LVRS. Mid-term pulmonary function 3 years after surgery can be decreased to the level at 3 months after surgery. Three years after LVRS, lung volume and pulmonary ventilation function can be significantly improved, but the improvement in gas exchange function was not significant.

摘要

背景

目前,肺减容手术(LVRS)已成为治疗某些严重慢性阻塞性肺疾病(COPD)病例的最有效方法之一。我们评估了LVRS对重度COPD患者肺功能的中期影响。

方法

10例年龄在38 - 70岁的重度COPD男性患者接受了LVRS,并在手术前、术后3个月和3年评估了他们的肺功能。肺量计和气体交换参数包括残气量、肺总量、吸气量、用力肺活量、一秒用力呼气量、一氧化碳弥散量和动脉血气。进行了6分钟步行距离(6MWD)测试。

结果

关于术前评估,大多数肺量计参数和6MWD在LVRS术后3个月显著改善,术后3年略有改善。气体交换参数在术后3个月显著改善,但3年后恢复到术前水平。

结论

LVRS可能显著改善适合LVRS的重度COPD患者的肺功能。术后3年的中期肺功能可降至术后3个月时的水平。LVRS术后3年,肺容积和肺通气功能可显著改善,但气体交换功能改善不显著。

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