Department of Respiratory Medicine, Royal Brompton Hospital, London, UK.
National Heart and Lung Institute, Imperial College, London, UK.
Respirology. 2020 Sep;25(9):972-980. doi: 10.1111/resp.13835. Epub 2020 May 3.
Patients with severe emphysema have limited treatment options and only derive a small benefit from optimal medical treatment. The only other therapy to have significant clinical beneficial effect in emphysema is LVRS but the perceived risk and invasiveness of surgery has fuelled bronchoscopic approaches to induce lung volume reduction. There are multiple bronchoscopic methods for achieving volume reduction in severe emphysema: EBV, airway bypass procedure, endobronchial coils, thermal (vapour) sclerosis and chemical sclerosis (sealants). Optimal patient selection is key to successful patient outcomes. This review discusses bronchoscopic approaches for emphysema treatment which has progressed through clinical trials to clinical practice.
严重肺气肿患者的治疗选择有限，即使接受最佳的药物治疗，也只能获得很小的益处。在肺气肿中，唯一具有显著临床获益的其他治疗方法是 LVRS，但手术的风险和侵袭性促使人们寻求支气管镜介入来实现肺减容。有多种支气管镜方法可用于治疗严重肺气肿：EBV、气道旁路手术、支气管内线圈、热（蒸汽）硬化和化学硬化（密封剂）。最佳的患者选择是获得成功治疗结果的关键。本综述讨论了肺气肿治疗的支气管镜方法，该方法已通过临床试验进展到临床实践。
