[重度肺气肿中瓣膜内镜下肺减容术疗效的预测]
[Prediction of the efficiency of endoscopic lung volume reduction by valves in severe emphysema].
作者信息
Bocquillon V, Briault A, Reymond E, Arbib F, Jankowski A, Ferretti G, Pison C
机构信息
Clinique universitaire de pneumologie, pôle thorax et vaisseaux, CHU de Grenoble, CS10217, 38043 Grenoble cedex 9, France; Université Grenoble Alpes, 38000 Grenoble, France.
Clinique universitaire de pneumologie, pôle thorax et vaisseaux, CHU de Grenoble, CS10217, 38043 Grenoble cedex 9, France; Université Grenoble Alpes, 38000 Grenoble, France.
出版信息
Rev Mal Respir. 2016 Nov;33(9):794-798. doi: 10.1016/j.rmr.2016.02.011. Epub 2016 Jul 18.
INTRODUCTION
In severe emphysema, endoscopic lung volume reduction with valves is an alternative to surgery with less morbidity and mortality. In 2015, selection of patients who will respond to this technique is based on emphysema heterogeneity, a complete fissure visible on the CT-scan and absence of collateral ventilation between lobes. Our case report highlights that individualized prediction is possible.
CASE REPORT
A 58-year-old woman had severe, disabling pulmonary emphysema. A high resolution thoracic computed tomography scan showed that the emphysema was heterogeneous, predominantly in the upper lobes, integrity of the left greater fissure and no collateral ventilation with the left lower lobe. A valve was inserted in the left upper lobe bronchus. At one year, clinical and functional benefits were significant with complete atelectasis of the treated lobe.
CONCLUSION
The success of endoscopic lung volume reduction with a valve can be predicted, an example of personalized medicine.
引言
在重度肺气肿中，使用瓣膜进行内镜下肺减容术是一种手术替代方案，其发病率和死亡率较低。2015年，选择对该技术有反应的患者基于肺气肿的异质性、CT扫描上可见的完整叶间裂以及叶间无侧支通气。我们的病例报告强调了个体化预测是可行的。
病例报告
一名58岁女性患有严重的致残性肺气肿。高分辨率胸部计算机断层扫描显示肺气肿是异质性的，主要位于上叶，左肺斜裂完整，与左肺下叶无侧支通气。在左肺上叶支气管插入了一个瓣膜。一年时，治疗肺叶完全肺不张，临床和功能获益显著。
结论
使用瓣膜进行内镜下肺减容术的成功可以预测，这是个性化医疗的一个例子。
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