Little A G, Swain J A, Nino J J, Prabhu R D, Schlachter M D, Barcia T C
Department of Surgery, University of Nevada School of Medicine, Las Vegas, USA.
Ann Surg. 1995 Sep;222(3):365-71; discussion 371-4. doi: 10.1097/00000658-199509000-00013.
The authors determined the role of Nd:YAG laser reduction pneumonoplasty for selected patients with diffuse emphysema.
The study is based on the concepts introduced 30 years ago by Brantigan regarding the value of lung reduction surgery in patients with emphysema. The authors used minimally invasive techniques with the hopes of providing appropriate clinical results with the least surgical morbidity.
Fifty-five patients with advanced symptomatic emphysema were treated with unilateral Nd:YAG laser reduction pneumonoplasty to achieve lung volume reduction.
Patients experienced significant improvement in exercise capacity and relief of breathlessness. This correlated with improvement in objective measures of pulmonary function and with reduction in lung volume by radiographic and spirometric measures. Significant associated hospital morbidity and a 5.5% mortality were associated.
These encouraging results with treatment of only one lung will be built on with both sequential lung and simultaneous, bilateral lung treatment protocols.
作者确定了钕钇铝石榴石(Nd:YAG)激光减容肺成形术在特定弥漫性肺气肿患者中的作用。
本研究基于30年前布兰特igan提出的关于肺气肿患者肺减容手术价值的概念。作者采用微创技术,希望以最低的手术发病率获得合适的临床效果。
55例有症状的晚期肺气肿患者接受了单侧Nd:YAG激光减容肺成形术以实现肺容积减少。
患者的运动能力显著改善,呼吸困难缓解。这与肺功能客观指标的改善以及通过影像学和肺量计测量的肺容积减少相关。存在显著的相关医院发病率及5.5%的死亡率。
仅对一侧肺进行治疗所取得的这些令人鼓舞的结果,将通过序贯肺治疗和同期双侧肺治疗方案得以拓展。