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支气管镜下肺减容线圈治疗对动脉血气的影响。

Effects of Bronchoscopic Lung Volume Reduction Coil Treatment on Arterial Blood Gases.

作者信息

Gülsen Askin

机构信息

Division of Clinical and Molecular Allergology, Research Center Borstel, Airway Research, Center North (ARCN), Borstel, Germany.

出版信息

J Bronchology Interv Pulmonol. 2019 Apr;26(2):90-95. doi: 10.1097/LBR.0000000000000529.

DOI:10.1097/LBR.0000000000000529
PMID:30640825
Abstract

BACKGROUND

Bronchoscopic lung volume reduction (BLVR) coil treatment is an increasingly used treatment modality for selected severe emphysema patients in recent years. Emphysema causes dynamic hyperinflation, loss of elastic recoil, air trapping, and decreased exercise capacity in advanced stages. This process progresses over time, leading to hypoxic and hypercapnic respiratory failure. The goal of this study is to elucidate the effects of BLVR coil treatment on arterial blood gas parameters in severe emphysema patients with respiratory failure.

METHODS

This is a retrospective study performed at a single pneumology center in Turkey. In total, this study included 39 patients diagnosed with severe emphysema who underwent bilateral BLVR coil treatment according to the general inclusion and exclusion criteria in the literature. The patients baseline and 12-month data were collected from medical records.

RESULTS

Twelve months after BLVR coil treatment, significant improvements were observed in patients' pulmonary function tests, an increase in partial pressure of oxygen in arterial blood (PaO2) from 58.05±9.36 to 73.82±13.3 (P<0.000) and decrease in partial pressure of carbon dioxide in arterial blood (PaCO2) of hypercapnic patients (from 51.60±4.1 to 46.55±6.6 mm Hg; P=0.001).

CONCLUSION

BLVR coil treatment is reliable and effective in emphysema patients who have hypoxic or mild hypercapnic respiratory failure. Besides improving lung function, BLVR coil treatment can significantly increase PaO2 and decrease PaCO2 in the medium term.

摘要

背景

近年来,支气管镜肺减容(BLVR)线圈治疗越来越多地用于特定的重度肺气肿患者。肺气肿会导致动态肺过度充气、弹性回缩丧失、气体潴留,晚期还会导致运动能力下降。这个过程会随着时间的推移而进展,导致低氧和高碳酸血症性呼吸衰竭。本研究的目的是阐明BLVR线圈治疗对重度肺气肿呼吸衰竭患者动脉血气参数的影响。

方法

这是在土耳其一个单一的肺病中心进行的一项回顾性研究。本研究共纳入39例根据文献中的一般纳入和排除标准接受双侧BLVR线圈治疗的重度肺气肿患者。从病历中收集患者的基线数据和12个月的数据。

结果

BLVR线圈治疗12个月后,患者的肺功能测试有显著改善,动脉血氧分压(PaO2)从58.05±9.36升至73.82±13.3(P<0.000),高碳酸血症患者的动脉血二氧化碳分压(PaCO2)降低(从51.60±4.1降至46.55±6.6 mmHg;P=0.001)。

结论

BLVR线圈治疗对低氧或轻度高碳酸血症呼吸衰竭的肺气肿患者可靠且有效。除改善肺功能外,BLVR线圈治疗在中期可显著提高PaO2并降低PaCO2。

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