Roeslin N, Weitzenblum E, Meunier-Carus J, Witz J P
Rev Fr Mal Respir. 1980;8(2):132-42.
45 patients exhibiting a diffuse emphysema associated with voluminous emphysematous bullae underwent surgical resection of the bullae. They were then regularly followed-up. Pulmonary function investigations were performed preoperatively in 38 patients at 6 months, 1 year and 3-7 years after resection. Postoperative subjective improvement was experienced by all patients, but diminished progressively with years. An associated chronic bronchitis was a predictor of bad prognosis. Vital capacity increased whereas plethysmographic residual volume and TLC decreased post-operatively, due to the recovery of available pulmonary parenchyma. The improvement of bronchial obstruction was probably related to the increased elastic recoil pressure. Hypoxemia also improved in most cases. In patients having undergone a second resection (controlateral lung), functional improvement progressively disappeared as the emphysematous disease progressed.
45例患有弥漫性肺气肿并伴有大量肺大疱的患者接受了肺大疱手术切除。随后对他们进行定期随访。38例患者在术前、切除术后6个月、1年以及3至7年进行了肺功能检查。所有患者术后主观症状均有改善,但随着时间推移逐渐减弱。合并慢性支气管炎是预后不良的一个预测因素。由于可用肺实质的恢复,术后肺活量增加,而体积描记法测定的残气量和肺总量减少。支气管阻塞的改善可能与弹性回缩压力增加有关。大多数病例中低氧血症也有所改善。接受二次切除(对侧肺)的患者,随着肺气肿病情进展,功能改善逐渐消失。