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肺气肿型慢性阻塞性肺疾病(COPD)患者的瓣膜治疗:从随机试验到临床实践中的患者选择

Valve therapy in patients with emphysematous type of chronic obstructive pulmonary disease (COPD): from randomized trials to patient selection in clinical practice.

作者信息

Valipour Arschang

机构信息

Department of Respiratory and Critical Care Medicine, Ludwig-Boltzmann-Institute for COPD and Respiratory Epidemiology, Otto-Wagner-Spital, Sanatoriumsstrasse 2, 1140 Wien, Austria.

出版信息

J Thorac Dis. 2018 Aug;10(Suppl 23):S2780-S2796. doi: 10.21037/jtd.2018.08.86.

Abstract

In recent years a number of endoscopic methods have emerged to treat patients with severe emphysematous type of chronic obstructive pulmonary disease (COPD), who are primarily symptomatic due to hyperinflation despite optimal medical management. Of these techniques, implantation of endobronchial one-way valves into targeted airways of isolated emphysematous lobes appears to be one of the most promising innovations. Results from randomized controlled trials of valve therapy for emphysema show consistent benefits in terms of lung function, exercise capacity, symptoms, and quality of life. This review aims to provide a comprehensive summary of the currently available scientific data, discussion of typical treatment related side effects, and recommendations for patient selection in clinical practice.

摘要

近年来,出现了多种内镜治疗方法,用于治疗重度气肿型慢性阻塞性肺疾病(COPD)患者,这些患者尽管接受了最佳药物治疗,但主要症状仍是肺过度充气。在这些技术中,将支气管内单向瓣膜植入孤立性气肿肺叶的目标气道似乎是最有前景的创新之一。肺气肿瓣膜治疗的随机对照试验结果显示,在肺功能、运动能力、症状和生活质量方面均有持续益处。本综述旨在全面总结当前可用的科学数据,讨论典型的治疗相关副作用,并为临床实践中的患者选择提供建议。

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