Giang Nguyen Truong, Ngoc Trung Nguyen, Nam Nguyen Van, Nhung Nguyen Viet, Thang Ta Ba, Hung Dong Khac, Bac Nguyen Duy, Toi Chu Dinh, Hung Pham Ngoc
Department of Cardiothoracic Surgery, Vietnam Military Medical University, Hanoi, Vietnam.
Vietnam National Lung Hospital, Hanoi, Vietnam.
Open Access Maced J Med Sci. 2019 Dec 20;7(24):4389-4392. doi: 10.3889/oamjms.2019.841. eCollection 2019 Dec 30.
Lung volume reduction surgery (LVRS) was introduced to alleviate clinical conditions in selected patients with heterogenous emphysema. Clarifying the most suitable patients for LVRS remained unclear.
This study was undertaken to specifically analyze the preoperative factor affecting to LVRS.
The prospective study was conducted at 103 Military Hospital between July 2014 and April 2016. Severe heterogenous emphysema patients were selected to participate in the study. The information, spirometry, and body plethysmographic pulmonary function tests in 31 patients who underwent LVRS were compared with postoperative outcomes (changing in FEV1 and CAT scale).
Of the 31 patients, there was statistically significant difference in the outcome of functional capacity, lung function between two groups (FEV1 ≤ 50% and > 50%) (∆FEV1: 22.46 vs 18.32%; p = 0.042. ∆ CAT: 6.85 vs 5.07; p = 0.048). Changes of the FEV1 and CAT scale were no statistically significant differences in three groups residual volume. Patients with total lung capacity < 140% had more improved than others (∆FEV1: 23.81 vs 15.1%; p = 0.031).
Preoperative spirometry and body plethysmographic pulmonary function tests were useful measures to selected severe heterogenous emphysema patients for LVRS. Patients with FEV1 ≤ 50%, TLC in the range of 100-140% should be selected.
肺减容手术（LVRS）被引入以缓解特定的异质性肺气肿患者的临床症状。然而，确定最适合接受LVRS的患者仍不明确。
本研究旨在具体分析影响LVRS的术前因素。
前瞻性研究于2014年7月至2016年4月在第103医院进行。选择重度异质性肺气肿患者参与研究。将31例行LVRS患者的信息、肺量计检查和体容积描记法肺功能测试结果与术后结果（第一秒用力呼气容积[FEV1]变化和慢性阻塞性肺疾病评估测试[CAT]量表）进行比较。
31例患者中，两组（FEV1≤50%和>50%）在功能能力、肺功能结果方面存在统计学显著差异（∆FEV1：22.46%对18.32%；p = 0.042。∆CAT：6.85对5.07；p = 0.048）。三组残气量中FEV1和CAT量表的变化无统计学显著差异。肺总量<140%的患者比其他患者改善更明显（∆FEV1：23.81%对15.1%；p = 0.031）。
术前肺量计检查和体容积描记法肺功能测试是选择重度异质性肺气肿患者进行LVRS的有用措施。应选择FEV1≤50%、肺总量在100 - 140%范围内的患者。
