电视胸腔镜辅助小切口行双侧肺减容术治疗重度肺气肿  

Thoracoscopic-assisted bilateral lung volume reduction surgery for severe pulmonary emphysema with small incision

作　　者：吴永国 宋晓军 丛波[2] 彭传亮[2] 孙启峰[2] 赵小刚[2] 

机构地区：[1]滨州阳信县人民医院,山东滨州251800 [2]山东大学第二医院

出　　处：《腹腔镜外科杂志》2009年第6期411-413,共3页Journal of Laparoscopic Surgery

摘　　要：目的:评价电视胸腔镜辅助小切口行双侧肺减容术治疗重度肺气肿的疗效,并总结围术期的处理经验。方法:回顾分析2006年以来为18例重度肺气肿患者实施肺减容术的临床资料,对比分析手术前后肺功能指标和动脉血氧分压的变化。结果:本组无手术死亡病例,2例合并急性呼吸衰竭。术后随访半年,平均第1秒用力呼气量增加39.2%,用力肺活量增加20.1%,残气量下降26.5%,肺总量下降23.1%,动脉血氧分压平均上升15.1%,与术前相比差异有统计学意义(P<0.05)。结论:电视胸腔镜辅助小切口行双侧肺减容术是经济有效的治疗方法,能明显改善重度肺气肿患者的临床症状和生理状况,增加活动能力。Objective： To evaluate the therapeutic effect of thoracoscopic-assisted bilateral lung volume reduction surgery （LVRS） for severe pulmonary emphysema with small incision, and summarize the experience of perioperative period. Methods： The clinical date of 18 patients with severe emphysema underwent LVRS since 2006 were analyzed retrospectively, preoperative and postoperative lung function parameter and arterial partial pressure of oxygen （ PaO2 ） were comparatively analyzed. Results ： There was no operative death. Postoperative complication included acute respiratory failure in 2 patients. In the follow-up of half a year, the mean forced expiratory volume in the first second （FEV1）, forced vital capacity （FVC）and PaO2 were significantly increased by 39.2% ,20.1% and 15.1% respectively. Residual volume （RV） and total lung capacity （TLC） were markedly decreased by 26.5% and 23.1% respectively. Compared with preoperative parameters, the differences were significant （ P 〈 0.05 ）. Conclusions ： Thoracoscopic-assisted bilateral LVRS for severe pulmonary emphysema with small incision is an economic and effective method, which can dramatically improve the clinical symptom and physiologic condition of patients with severe pulmonary emphysema, increase locomotor activity of them.

关 键 词：胸腔镜术 肺气肿 肺切除术 围手术期 

分 类 号：R655.3[医药卫生—外科学]