6例经支气管内单向活瓣支架治疗COPD的临床疗效回顾性分析  

Retrospective Analysis of Clinical Efficacy of Six Cases of Transbronchial One-way Valve in the Treatment of COPD

作　　者：胡妙芬 林立 张良基 汪铁柱 李浩 叶煜铭 HU Miaofen;LIN Li;ZHANG Liangji;WANG Tiezhu;LI Hao;YE Yuming(Department of Respiratory and Critical Care Medicine,Zhangzhou Hospital,Fujian Medical University,Zhangzhou,Fujian Province,363000 China)

机构地区：[1]福建医科大学附属漳州市医院呼吸与危重症医学科,福建漳州363000

出　　处：《中外医疗》2021年第30期68-72,共5页China & Foreign Medical Treatment

摘　　要：目的探讨支气管内单向活瓣支架在COPD患者当中的临床疗效。方法回顾性分析2018年4月—2021年4月于该院行支气管内单向瓣膜支架术的6例COPD患者的一般资料,分析肺功能、影像变化、6 min步行距离(6 MWD)、改良英国医学研究学会呼吸困难指数(mMRC)、慢性阻塞性肺疾病评估(CAT评分)、并发症结果。结果经支气管镜于靶区段支气内置入单向阀瓣膜支架可改善COPD患者术后1、3个月的呼出气第1秒力占预计值比(FEV1%pred)、CAT评分、6 MWD,术后6个月、1年疗效改善不明显甚至略有所下降;常见手术并发症为痰栓、瓣膜开合欠佳、气胸、肉芽、移位、感染,2例因感染取出支架,1例效果不佳取出;2例出现自发性气胸经置管引流后拔管好转,患者评估指标仍改善。结论COPD患者行支气管内单向阀瓣膜支架对近期患者的肺功能、活动耐量及CAT评分均有改善,并发自发性气胸经治疗后不影响EBV的疗效,但是由于并发症等因素远期疗效仍值得进一步探讨。Objective To investigate the clinical efficacy of intrabronchial one-way valve in COPD patients.Methods A retrospective analysis was conducted on lung function,imaging changes,6-minute walking test(6 MWD),improved British Medical Research Council Dyspnea Index(mMRC),chronic obstructive pulmonary disease assessment(CAT Score)and complications of 6 patients with COPD who underwent endobronchial unidirectional valve stenting in the hospital from April 2018 to April 2021.Results Bronchoscopic implantation of a one-way valve stent into the target segment bronchi can improve the ratio of the first second of the expiratory force to the predicted value(FEV1%pred),CAT score,and 6 MWD in patients with COPD in the first and third months after surgery.At 6 months and 1 year after the operation,the curative effect was not significantly improved or even decreased slightly.Common surgical complications are phlegm embolism,poor valve opening and closing,pneumothorax,granulation,displacement,and infection.The stent was removed in 2 cases due to infection,and the effect was poor in 1 case.Two cases of spontaneous pneumothorax were improved after extubation by catheter drainage,and the patient evaluation indicators were still improved.Conclusion The use of intrabronchial one-way valve for COPD patients can improve the lung function,activity tolerance and CAT score of patients in the short term.The treatment of spontaneous pneumothorax does not affect the efficacy of EBV,but the long-term efficacy due to complications and other factors is still worth further exploring.

关 键 词：COPD EBV 单向阀瓣膜支架 肺减容术 临床疗效 

分 类 号：R4[医药卫生—临床医学]