Guerra Miguel S, Miranda José António, Leal Francisco, Mota Joâo Carlos
Serviço de Cirurgia Cardio-Torácica do Centro Hospitalar de Vila Nova de Gaia, Porto.
Rev Port Cir Cardiotorac Vasc. 2009 Oct-Dec;16(4):205-8.
The prevalence of bronchiectasis has decreased significantly over recent decades in developed countries. However, resection for bronchiectasis still plays an important role in thoracic surgery practice in some countries such as Portugal. Between 1994 and 2004, 51 patients (29 female and 22 male) with a mean age of 38.6 years (range, 4-65 years) underwent pulmonary resection for bronchiectasis. Mean duration of symptoms was 4.8 years. Surgery was indicated because of unsuccessful medical therapy in 25 patients (49.1%), hemoptysis in 12 (23.5%), lung mass in 9 (17.6%) and lung abscess in 5 (9.8%). The surgical treatment was as follows: pneumectomy in 7 patients, bilobectomy in 3, lobectomy in 36 segmentectomy in 5. There was no operative mortality. Complications occurred in 8 patients and the morbidity rate was 15.7%. Follow-up was complete in 45 (88.2%) patients with a mean of 3.4 years. Overall, 35 (77.7%) patients were asymptomatic after surgery symptoms were improved in 7 (15.6%). Unsuccessful medical therapy was still our main indication for surgery of bronchiectasis, despite aggressive antibiotic therapy. Surgical resection was performed with acceptable morbidity and morbility rates and markedly improved symptoms in the majority of patients.
在发达国家，近几十年来支气管扩张症的患病率显著下降。然而，在一些国家如葡萄牙，支气管扩张症的手术切除在胸外科实践中仍发挥着重要作用。1994年至2004年间，51例患者（29例女性和22例男性）接受了支气管扩张症的肺切除术，平均年龄为38.6岁（范围4 - 65岁）。症状的平均持续时间为4.8年。手术指征为：25例患者（49.1%）药物治疗无效，12例（23.5%）咯血，9例（17.6%）肺部肿块，5例（9.8%）肺脓肿。手术治疗方式如下：7例全肺切除术，3例双叶切除术，36例肺叶切除术，5例肺段切除术。无手术死亡病例。8例患者出现并发症，发病率为15.7%。45例（88.2%）患者完成随访，平均随访时间为3.4年。总体而言，35例（77.7%）患者术后无症状，7例（15.6%）患者症状改善。尽管进行了积极的抗生素治疗，但药物治疗无效仍是我们进行支气管扩张症手术的主要指征。手术切除的发病率和死亡率可接受，且大多数患者的症状明显改善。
