Brenner M, Yusen R, McKenna R, Sciurba F, Gelb A F, Fischel R, Swain J, Chen J C, Kafie F, Lefrak S S
Pulmonary and Critical Care Medicine Division, UC Irvine Medical Center, Orange 92668, USA.
Chest. 1996 Jul;110(1):205-18. doi: 10.1378/chest.110.1.205.
There has been dramatic resurgence of interest in surgical treatment of emphysema, particularly "lung volume reduction" procedures. Recent studies have demonstrated improvements in pulmonary function, lung mechanics, exercise tolerance, and quality of life in selected patients following volume reduction procedures. However, considerable uncertainty remains regarding overall benefit, optimal patient selection, operative techniques, and duration of response. This summarizes current approaches to lung volume reduction surgery, available clinical outcome information, selection criteria, and physiologic mechanisms of response, and discusses the potential role for surgical volume reduction in treatment of emphysema. Recent data appear to support the efficacy of bilateral staple lung volume reduction surgery in patients with severe symptomatic heterogeneously distributed emphysema. Further studies will be needed to determine relative value of different operative techniques and benefit in patients with other clinical presentations.
人们对肺气肿的外科治疗，尤其是“肺减容”手术的兴趣已急剧复苏。最近的研究表明，在进行肺减容手术后，部分患者的肺功能、肺力学、运动耐量和生活质量有所改善。然而，在总体获益、最佳患者选择、手术技术及疗效持续时间方面仍存在相当大的不确定性。本文总结了当前肺减容手术的方法、可用的临床结果信息、选择标准及反应的生理机制，并讨论了外科减容在肺气肿治疗中的潜在作用。最近的数据似乎支持双侧钉合肺减容手术对严重症状性、异质性分布肺气肿患者的疗效。还需要进一步研究来确定不同手术技术的相对价值以及对其他临床表现患者的益处。
