Koegelenberg Coenraad Frederik N, Theron Johan, Bruwer J W, Allwood Brian W, Vorster Morné J, von Groote-Bidlingmaier Florian, Dheda Keertan
Pulmonology and Critical Care, Stellenbosch University and Tygerberg Academic Hospital, Tygerberg, Cape Town, South Africa.
S Afr Med J. 2015 Sep 14;105(9):721-3. doi: 10.7196/SAMJnew.8144.
Therapeutic options in severe emphysema are limited. Endoscopic lung volume reduction (ELVR) refers to bronchoscopically inducing volume loss to improve pulmonary mechanics and compliance, thereby reducing the work of breathing. Globally, this technique is increasingly used as treatment for advanced emphysema with the aim of obtaining similar functional advantages to surgical lung volume reduction, while reducing risks and costs. There is a growing body of evidence that certain well-defined subgroups of patients with advanced emphysema benefit from ELVR, provided that a systematic approach is followed and selection criteria are met. In addition to endobronchial valves, ELVR using endobronchial coils is now available in South Africa. The high cost of these interventions underscores the need for careful patient selection to best identify those likely to benefit from such procedures.
重度肺气肿的治疗选择有限。内镜下肺减容术（ELVR）是指通过支气管镜诱导肺容积减少，以改善肺力学和顺应性，从而减轻呼吸功。在全球范围内，这项技术越来越多地被用于治疗晚期肺气肿，目的是获得与外科肺减容术相似的功能优势，同时降低风险和成本。越来越多的证据表明，只要采用系统的方法并满足选择标准，某些明确界定的晚期肺气肿亚组患者可从ELVR中获益。除了支气管内瓣膜，南非现已可使用支气管内线圈进行ELVR。这些干预措施的高成本凸显了仔细选择患者的必要性，以便最好地识别那些可能从此类手术中获益的患者。
