DeCamp Malcolm M, Lipson David, Krasna Mark, Minai Omar A, McKenna Robert J, Thomashow Byron M
Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Proc Am Thorac Soc. 2008 May 1;5(4):427-31. doi: 10.1513/pats.200707-087ET.
Potential candidates for lung volume reduction surgery should undergo extensive evaluation and preparation to minimize perioperative risks and optimize surgical outcomes. Initial screening includes spirometry, diffusion capacity, lung volumes by body plethysmography, and high-resolution computerized tomography scanning. Patients who have been successfully screened must complete a preoperative pulmonary rehabilitation program of 6-10 weeks duration. During the pulmonary rehabilitation program, medical therapy should be maximized. Postrehabilitation studies include cardiopulmonary exercise testing, arterial blood gas analysis, oxygen titration, six-minute walk, and cardiac testing. The evaluation process aims at defining the severity and distribution of emphysema and attempts to eliminate those who do not meet criteria outlined by the National Emphysema Treatment Trial. Optimal candidates have upper-lobe-predominant emphysema and acceptable operative risks.
肺减容手术的潜在候选人应接受全面评估和准备，以尽量降低围手术期风险并优化手术效果。初始筛查包括肺活量测定、弥散功能、体容积描记法测定肺容积以及高分辨率计算机断层扫描。成功通过筛查的患者必须完成为期6至10周的术前肺康复计划。在肺康复计划期间，应最大限度地进行药物治疗。康复后检查包括心肺运动试验、动脉血气分析、氧滴定、六分钟步行试验和心脏检查。评估过程旨在确定肺气肿的严重程度和分布情况，并试图排除那些不符合国家肺气肿治疗试验所规定标准的患者。最佳候选人患有以上叶为主的肺气肿且手术风险可接受。
