Fischel R J, McKenna R J, Gelb A, Singh N, Brenner M
Lung Center, Chapman Medical Center, Orange, California, USA.
West J Med. 1998 Aug;169(2):74-7.
Our experience with lung volume reduction surgery for emphysema now encompasses more than 300 cases, including several prospective trials. We have a 3.5% operative mortality rate and, with aggressive use of Heimlich valves over the past 6 months, an average hospital length of stay of 8 days. Proper patient selection is essential and can be based primarily on results of pulmonary function tests (PFTs), ventilation/perfusion (V/Q) scans, and computed tomography (CT) scans. We have found that bilateral is more effective than unilateral staple lung volume reduction surgery, which is in turn better than unilateral laser surgery. In patients with bilateral upper lobe disease, average FEV1 (forced expiratory volume in a 1-second interval) improvement is 82%; overall, it is 61% (range -33 to 217%). We conclude that lung volume reduction surgery can be performed safely with acceptable mortality and excellent clinical results in properly selected, motivated patients.
我们进行肺气肿肺减容手术的经验现已涵盖300多例病例，包括几项前瞻性试验。我们的手术死亡率为3.5%，并且在过去6个月积极使用海姆利希瓣膜的情况下，平均住院时间为8天。正确选择患者至关重要，主要可依据肺功能测试（PFT）、通气/灌注（V/Q）扫描和计算机断层扫描（CT）扫描的结果。我们发现双侧手术比单侧吻合器肺减容手术更有效，而单侧吻合器肺减容手术又比单侧激光手术更好。在双侧上叶疾病患者中，平均第1秒用力呼气量（FEV1）改善率为82%；总体而言，改善率为61%（范围为-33%至217%）。我们得出结论，在经过适当选择且有积极性的患者中，肺减容手术可以安全进行，死亡率可接受，临床效果良好。
