Ernst Armin, Anantham Devanand
Pulmonary, Critical Care and Sleep Medicine, St. Elizabeth Medical Center, VP Thoracic Disease and Critical Care Service Line, Caritas Christi Health Care, Seton 6 East, 736 Cambridge Street, Brighton, MA 02135, USA.
Pulm Med. 2011;2011:610802. doi: 10.1155/2011/610802. Epub 2010 Dec 9.
The application of lung volume reduction surgery in clinical practice is limited by high postoperative morbidity and stringent selection criteria. This has been the impetus for the development of bronchoscopic approaches to lung volume reduction. A range of different techniques such as endobronchial blockers, airway bypass, endobronchial valves, thermal vapor ablation, biological sealants, and airway implants have been employed on both homogeneous as well as heterogeneous emphysema. The currently available data on efficacy of bronchoscopic lung volume reduction are not conclusive and subjective benefit in dyspnoea scores is a more frequent finding than improvements on spirometry or exercise tolerance. Safety data are more promising with rare procedure-related mortality, few serious complications, and short hospital length of stay. The field of bronchoscopic lung volume reduction continues to evolve as ongoing prospective randomized trials build on earlier feasibility data to clarify the true efficacy of such techniques.
肺减容手术在临床实践中的应用受到术后高发病率和严格选择标准的限制。这推动了支气管镜下肺减容方法的发展。一系列不同技术，如支气管内封堵、气道旁路、支气管内瓣膜、热蒸汽消融、生物密封剂和气道植入物，已应用于均匀性和非均匀性肺气肿。目前关于支气管镜肺减容疗效的现有数据尚无定论，呼吸困难评分的主观改善比肺功能测定或运动耐量的改善更为常见。安全性数据更具前景，手术相关死亡率罕见，严重并发症少，住院时间短。随着正在进行的前瞻性随机试验在早期可行性数据的基础上进一步明确此类技术的真正疗效，支气管镜肺减容领域不断发展。
