Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania.
Respir Care. 2023 Jul;68(7):939-960. doi: 10.4187/respcare.10825.
Many patients suffer from complaints of dyspnea, cough, and sputum production, clinical symptoms that hallmark the structural abnormalities that are present in patients with COPD. Although pharmacologic and non-pharmacologic medical therapies help reduce these symptoms, many of these symptoms, especially dyspnea, remain unchecked and contribute to the burden of disease in patients with COPD. Over the last 3 decades, several surgical and interventional treatments delivered via a bronchoscopic approach have been developed to complement medical therapies and show promise to improve patient outcomes. Surgical and interventional treatments target structural abnormalities of the airway and lung parenchyma that can be identified with a combination of imaging and physiological testing, factors that are key to select patients most likely to benefit from these treatments. This paper reviews surgical and bronchoscopic interventional treatment options for patients with emphysema and airways disorders.
许多患者都有呼吸困难、咳嗽和咳痰等症状,这些症状是 COPD 患者存在结构异常的标志。虽然药物和非药物的医学治疗有助于减轻这些症状,但这些症状中的许多,特别是呼吸困难,仍然无法控制,并导致 COPD 患者的疾病负担加重。在过去的 30 年中,已经开发了几种通过支气管镜途径进行的手术和介入治疗方法,以补充医学治疗,并有望改善患者的治疗效果。手术和介入治疗针对的是气道和肺实质的结构异常,这些异常可以通过影像学和生理测试的组合来识别,这些因素是选择最有可能从这些治疗中获益的患者的关键。本文回顾了肺气肿和气道疾病患者的手术和支气管镜介入治疗选择。