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[介入性支气管镜检查:可行之事与合理之举?]

[Interventional Bronchoscopy: What is Possible and What Makes Sense?].

作者信息

Sarmand Nilab, Gompelmann Daniela

机构信息

Pneumologie und Beatmungsmedizin, Thoraxklinik am Universitätsklinikum Heidelberg.

Zentrum für Translationale Lungenforschung Heidelberg (TLRC-H), Deutsches Zentrum für Lungenforschung (DZL).

出版信息

Dtsch Med Wochenschr. 2018 Aug;143(15):1097-1102. doi: 10.1055/a-0551-2626. Epub 2018 Jul 30.

Abstract

Interventional bronchoscopy plays a significant role in the treatment of various pulmonary diseases. Different endoscopic therapeutic modalities are available for the management of central airway obstruction (CAO) that represent a common indication for interventional bronchoscopy. The latest development in the field of CAO management are biodegradable stents, that would maintain the airway patency over time, then gradually degrade and vanish from the airway. Other indications for interventional bronchoscopy are chronic obstructive pulmonary disease (COPD), emphysema, asthma and chronic bronchitis. Thereby, various techniques of endoscopic lung volume reduction (ELVR) that address at hyperinflation reduction extend the therapeutic spectrum of patients with severe emphysema. Targeted lung denervation that aims a persistent bronchodilation present an area of current research in the field of COPD and asthma. In patients with chronic bronchitis, cryospray therapy that is performed within clinical trials may reduce the amount of secretion.

摘要

介入性支气管镜检查在各种肺部疾病的治疗中发挥着重要作用。对于中央气道阻塞(CAO)的管理,有不同的内镜治疗方式可供选择,CAO是介入性支气管镜检查的常见适应症。CAO管理领域的最新进展是可生物降解支架,它能长期维持气道通畅,然后逐渐降解并从气道中消失。介入性支气管镜检查的其他适应症包括慢性阻塞性肺疾病(COPD)、肺气肿、哮喘和慢性支气管炎。因此,各种旨在减少肺过度充气的内镜下肺减容(ELVR)技术扩展了重度肺气肿患者的治疗范围。旨在实现持续支气管扩张的靶向肺去神经支配是COPD和哮喘领域当前的研究方向。在慢性支气管炎患者中,临床试验中进行的冷冻喷雾治疗可能会减少分泌物量。

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