Meyers B F, Yusen R D, Lefrak S S, Patterson G A, Pohl M S, Richardson V J, Cooper J D
Division of Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Ann Thorac Surg. 1998 Aug;66(2):331-6. doi: 10.1016/s0003-4975(98)00499-8.
Lung volume reduction operation shows promise in relieving symptoms and improving function in highly selected patients with emphysema. Withdrawal of Medicare funding for patients selected for operation by standard criteria created a matched control group with which to compare lung volume reduction recipients.
A retrospective study was done comparing 22 volume reduction candidates denied operation with 65 contemporaneous and comparable volume reduction recipients. Baseline physiologic characteristics were compared and longitudinal measures of pulmonary function were followed up for 24 months.
Patients denied operation were similar to volume reduction recipients in all baseline measurements. Patients denied operation experienced a progressive worsening of their function, whereas volume reduction patients experienced sustained improvements. Absolute survival to date is 82% for the surgical group and 64% for the medical group.
The improvement seen in volume reduction patients cannot be attributed to the effects of patient selection or preoperative and postoperative rehabilitation.
对于经过严格筛选的肺气肿患者，肺减容手术在缓解症状和改善功能方面显示出前景。医疗保险取消了对按标准标准选择进行手术的患者的资金支持，从而创建了一个匹配的对照组，可用于与肺减容手术接受者进行比较。
进行了一项回顾性研究，将22名被拒绝手术的减容候选者与65名同期且具有可比性的减容手术接受者进行比较。比较了基线生理特征，并对肺功能的纵向指标进行了24个月的随访。
在所有基线测量中，被拒绝手术的患者与减容手术接受者相似。被拒绝手术的患者功能逐渐恶化，而减容手术患者功能持续改善。迄今为止，手术组的绝对生存率为82%，药物治疗组为64%。
减容手术患者所见到的改善不能归因于患者选择或术前及术后康复的影响。
