经支气管镜活瓣植入肺减容术治疗重度肺气肿36例疗效观察  

Efficacy of trans-endobronchial valves implantation lung volume reduction surgery in 36 patients with severe emphysema

作　　者：付鹏 龙发 黄文婷 陈明辉 董洪波 蒋慧 甘景帆 龙亮 FU Peng;LONG Fa;HUANG Wen-ting;CHEN Ming-hui;DONG Hong-bo;JIANG Hui;GAN Jing-fan;LONG Liang(Department of Respiratory and Critical Care Medicine,Shenzhen Hospital(Guangming),University of Chinese Academy of Sciences,Shenzhen,Guangdong 518106,China)

机构地区：[1]中国科学院大学深圳医院(光明)呼吸与危重医学科,广东深圳518106

出　　处：《临床肺科杂志》2022年第3期364-369,共6页Journal of Clinical Pulmonary Medicine

摘　　要：目的研究经支气管镜活瓣(EBV)植入肺减容术治疗重度肺气肿的疗效。方法回顾性分析从2016年10月~2019年2月,于我院实施EBV植入肺减容术治疗的36例重度肺气肿患者的相关病历资料,记为研究组。另取从2013年2月~2015年6月,于我院接受开胸肺减容术治疗的36例重度肺气肿患者作为对照组。比较治疗前后两组肺功能、生活质量、动脉血气分析以及并发症发生情况。结果治疗后12个月观察组的各项肺功能指标水平和对照组相比均不明显(P>0.05)。观察组治疗后12个月PaCO_(2)、PaO_(2)水平和对照组相比均不明显(均P>0.05)。观察组治疗后CAT评分、mMRC评分均低于对照组,而6MWT高于对照组(均P<0.05)。观察组并发症发生率低于对照组(P<0.05)。随访3个月、6个月、9个月观察组肺部感染发生率均低于对照组(P<0.05)。结论EBV植入肺减容术在改善重度肺气肿患者肺功能方面效果并不显著,但有利于改善生活质量以及运动耐量,安全性较好,值得临床推广应用。Objective To study the efficacy of trans-endobronchial valves(EBV)implantation in the treatment of severe emphysema.Methods From October 2016 to February 2019,36 patients with severe emphysema who underwent EBV implantation for lung volume reduction surgery in our hospital were retrospectively analyzed and recorded as the study group.Another 36 patients with severe emphysema who underwent thoracotomy and volume reduction surgery in our hospital from February 2013 to June 2015 were selected as the control group.Lung function,quality of life,arterial blood gas analysis,and complications were compared between the two groups before and after treatment.Results After 12 months of treatment,there was no significant difference between the study group and the control group concerning the indexes of lung function(P>0.05).The levels of PaCO_(2) and PaO_(2) in the study group did not change significantly compared with the control group(all P>0.05).After treatment,CAT score and mMRC score in the study group were lower than those in the control group,while 6MWT was higher than that in the control group(all P<0.05).The complication rate of the study group was lower than that of the control group(P<0.05).The incidence of pulmonary infection in the study group was lower than that in the control group after 3,6,and 9 months of follow-up(P<0.05).Conclusion EBV implantation for lung volume reduction surgery is not effective in improving lung function in patients with severe emphysema,but it is conducive to improving the quality of life and exercise tolerance.It shows favorable safetyand is worthy of clinical application.

关 键 词：重度肺气肿 支气管镜活瓣 肺减容术 疗效 生活质量 

分 类 号：R563.3[医药卫生—呼吸系统]