Department of Pneumology and Critical Care Medicine, Thoraxklinik, Heidelberg, Germany,
Translational Lung Research Center Heidelberg, German Lung Research Foundation, University of Heidelberg, Heidelberg, Germany,
Respiration. 2019;97(6):548-557. doi: 10.1159/000496122. Epub 2019 Mar 5.
Endoscopic lung volume reduction (ELVR) therapies are gaining prominence as a treatment option with guideline recommendations by COPD GOLD and NICE and the recent FDA approval for endobronchial valves. The transition from an experiment-based therapy only to clinical care comes with new challenges. A significant volume of evidence-based data has been published; all data demonstrate consistent improvements in several aspects of patient outcomes. Patients suffering from severe air trapping and thoracic hyperinflation seem to benefit the most from ELVR. In addition to lung function, baseline assessment should ideally include cardiopulmonary exercise testing, high-resolution computer tomography scan, perfusion scintigraphy, and echocardiography. This expert ELVR statement updates best practice recommendations from 2017 regarding patient selection and utilization of these various techniques for treating patients with advanced emphysema.
内镜下肺减容术（ELVR）作为一种治疗选择，越来越受到重视，COPD GOLD 和 NICE 指南推荐，以及最近 FDA 批准了支气管内瓣膜。从基于实验的治疗方法向临床护理的转变带来了新的挑战。大量基于证据的数据已经发表；所有数据都表明患者结局的多个方面都有一致的改善。患有严重空气潴留和胸内过度充气的患者似乎从 ELVR 中获益最多。除了肺功能外，基线评估还应包括心肺运动试验、高分辨率计算机断层扫描、灌注闪烁扫描和超声心动图。本专家 ELVR 声明更新了 2017 年关于患者选择和使用这些各种技术治疗晚期肺气肿患者的最佳实践建议。
