活瓣肺减容术研究进展  

Progresses in the endobronchial lung volume reduction with one-way valve

作　　者：高亚东[1] 戴莉[1] 黄革[1] 杨炯[1] 

机构地区：[1]武汉大学中南医院呼吸内科,430071

出　　处：《国际呼吸杂志》2016年第9期716-720,共5页International Journal of Respiration

摘　　要：COPD是临床常见的慢性气道炎症性疾病，具有较高的发病率和病死率。目前COPD的药物治疗主要是以吸入支气管舒张剂为主，辅以吸入性糖皮质激素等，来达到减少急性加重和延缓肺功能下降的目的。近10多年来，内镜下肺减容术（endoscopichial lung volume reduction，ELVR）已经在晚期肺气肿患者的治疗上获得有益尝试，在经过严格选择的患者可以取得较好的临床效果。ELVR有不同的手段，主要包括气道旁路、活瓣肺减容术、热蒸汽肺减容术和肺减容线圈。这些方法在作用机制、临床效果、适应证、并发症和可逆性等方面均存在差异。目前临床应用最为广泛的是单向活瓣肺减容术，其主要适应证是叶间裂完整的异质性肺气肿患者。近10年在世界范围的推广应用，在该方法的适应证、禁忌证、并发症，术前和术后的评估等方面均取得了大量的临床资料，加深了对该方法的理解，有助于优化临床应用。本文就活瓣肺减容术的有关研究进展作一综述。Chronic obstructive pulmonary disease （COPD） is a common airway inflammatory disease characterized by high morbidity and mortality. The standard pharmaceutical therapy for COPD is the inhaled bronchodilators combined with inhaled glucocorticoids, in order to reducing the frequency of acute exacerbation and the decline rate of lung function. In the past decades, endohronchial lung volume reduction （ELVR） has been introduced to the treatment of advanced emphysema. It has been proved to be effective to improve the life quality and lung function of strictly selected patients with heterogeneous emphysema. Different procedures have been developed for ELVR, including airway bypass fenestration, one-way valve implantation, lung volume reduction coils, and bronchoseopic thermal vapor ablation. These procedures are different in the action mechanisms, effectiveness, indications, contraindications, complications and reversibility. Among them, valve implantation is the most wide spread procedure around the world. Recent years, many clinical studies and observations have been conducted to better understanding the action mechanisms, indications and contraindications, assessment before and after the procedure and the prevention of complication. Here we reviewed these publications and try to clarify the importance of these studies.

关 键 词：肺气肿 内镜下肺减容术 单向活瓣 进展 

分 类 号：R563.9[医药卫生—呼吸系统]