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使用卡拉科卡切除球囊进行扩张刮宫术的慢性阻塞性肺疾病患者的随访结果:一项为期5年的188例病例系列研究。

Follow-up outcomes of chronic obstructive pulmonary disease patients who underwent dilatation and curettage with the Karakoca resector balloon: A 188-case series over 5 years.

作者信息

Karakoca Yalcin, Gogus Guler, Akduman Seha, Erturk Baykal

机构信息

Department of Chest Diseases, Medical Park Göztepe Hospital, Istanbul.

Medical Park Izmit Hospital, Izmit.

出版信息

Medicine (Baltimore). 2018 Nov;97(48):e13400. doi: 10.1097/MD.0000000000013400.

Abstract

We previously reported satisfactory results with the Karakoca resector balloon in 10 patients with stage IV chronic obstructive pulmonary disease (COPD) who did not respond to medical treatment. In this article, we present the outcomes of the Karakoca resector balloon dilatation and curettage technique in a larger case series (n = 188).A total of 188 COPD patients [mean age (SD): 69.2 (8.0) years; 46 females] classified as stage III to IV by the Global Initiative for Obstructive Lung Disease criteria underwent balloon desobstruction for segmental and subsegmental bronchi by therapeutic bronchoscopy. None of the patients could have achieved symptom relief even under high-dose inhaled bronchodilators and corticosteroids, oral corticosteroids, or oxygen and noninvasive mechanical ventilation therapy before the intervention. Forced expiratory volume in 1 s (FEV1) and oxygen saturation (SpO2) were measured, and modified Borg dyspnea scale (MBS) scores were determined before and 1 week and 1 month after the intervention.All patients were active smokers and 80% had concomitant chronic diseases. After the intervention, there was a notable reduction in the oxygen need of the patients. Comparison of lung function tests 1 week after the procedure with results before the procedure showed significant improvements in FEV1, MBS, and SpO2 levels (P < 0.001 for each), and the improvements were maintained for the entire postprocedural month (P < 0.001 for each). Except for 4 males, all patients were free of symptoms.These results confirmed our early observations that balloon dilatation and curettage is a safe and successful technique for medical treatment-resistant COPD.

摘要

我们之前报道了使用卡拉科卡切除球囊对10例IV期慢性阻塞性肺疾病(COPD)且药物治疗无效的患者取得了满意的结果。在本文中,我们展示了在更大病例系列(n = 188)中卡拉科卡切除球囊扩张及刮除术的结果。

根据慢性阻塞性肺疾病全球倡议标准,共有188例COPD患者[平均年龄(标准差):69.2(8.0)岁;46例女性]被分类为III至IV期,通过治疗性支气管镜对节段性和亚节段性支气管进行球囊去阻塞治疗。在干预前,即使使用高剂量吸入性支气管扩张剂和皮质类固醇、口服皮质类固醇,或吸氧及无创机械通气治疗,这些患者均未能实现症状缓解。测量了干预前、干预后1周和1个月的第1秒用力呼气量(FEV1)和血氧饱和度(SpO2),并确定了改良的博格呼吸困难量表(MBS)评分。

所有患者均为现吸烟者,80%伴有慢性疾病。干预后,患者的吸氧需求显著降低。将术后1周的肺功能测试结果与术前结果进行比较,结果显示FEV1、MBS和SpO2水平均有显著改善(每项P < 0.001),且在术后整个月内这些改善均得以维持(每项P < 0.001)。除4名男性外,所有患者均无症状。

这些结果证实了我们早期的观察结果,即球囊扩张及刮除术是治疗耐药性COPD的一种安全且成功的技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c33/6283145/6d91cf873678/medi-97-e13400-g001.jpg

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