Cooper J D, Patterson G A
Department of Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA.
Semin Thorac Cardiovasc Surg. 1996 Jan;8(1):52-60.
Lung volume reduction surgery is designed to alleviate symptoms of breathlessness and improve the quality of life for selected patients with severe emphysema. By resecting hyperinflated, nonfunctional areas of the lung, thoracic volume is reduced, chest wall and diaphragmatic mechanics are improved, and ventilation to the remaining portions of lung is improved. The operative procedure is designed to obtain maximum improvement with the least possible risk. Early mortality (less than 90 days) has been 3%, all from respiratory complications. Late mortality (more than 90 days) has been an additional 2%. Refinements in operative technique, including use of continuous staple line excision buttressed by bovine pericardium, creation of apical pleural tents, and avoidance of suction the chest tubes, have led to a steady decline in hospital stay, with the current average of 11 days and a median of 7 days. Ninety-nine of the 100 patients have been extubated at the end of the procedure, thus avoiding the need for postoperative ventilatory assistance.
肺减容手术旨在缓解重度肺气肿特定患者的呼吸困难症状并提高其生活质量。通过切除肺部过度膨胀的无功能区域，胸腔容积减小，胸壁和膈肌力学得到改善，肺其余部分的通气也得到改善。手术程序旨在以尽可能低的风险获得最大程度的改善。早期死亡率（不到90天）为3%，均因呼吸并发症所致。晚期死亡率（超过90天）为另外2%。手术技术的改进，包括使用牛心包支撑的连续钉合线切除、创建尖部胸膜帐篷以及避免对胸管进行吸引，已使住院时间稳步下降，目前平均为11天，中位数为7天。100例患者中有99例在手术结束时已拔除气管插管，从而避免了术后通气辅助的需要。
