胸腔镜肺减容术治疗重度肺气肿24例

目的探讨胸腔镜肺减容手术对重度肺气肿的治疗价值。方法对24例重度肺气肿患者行胸腔镜肺减容术。根据CT确定的靶区位置的不同,上下调整1个肋间切口位置。从后操作孔置入卵圆钳提起气肿性肺组织,前操作孔用45 mm Endo-G IA,沿预先设计的切割线围绕肺叶作∪或∩形的切割边缘。总肺减容组织在20%~30%。结果术后1个月肺部感染致呼吸衰竭2例,其中1例死亡,余呼吸困难明显减轻或消失。呼吸困难指数分级,Ⅰ级3例,Ⅱ级9例,Ⅴ级1例。获得6个月随访的15例病人肺功能均较术前显著改善。结论胸腔镜肺减容手术与开胸手术减容比较,效果类似,但胸腔镜肺减容术创伤小、恢复快,更安全。

Efficacy of Video-assisted Thoracoscopic Lung Volume Reduction Surgery on Chronic Obtauctive Pulmonary Disease

Objective To evaluate the efficacy of lung volume reduction surgery on severe chronic obstrutive pulmonary disease(COPD).Methods We made a three years' follow-up study on 24 patients who had accepted lung volume reduction surgery(LVRS) for severe COPD.Results The times of readmission of chronic bronchitis and pulmonary infection were significantly less in surgery group than in control group.The shortness of breath during going upstairs was alleviated.Not only the hour of oxygen inhalation was decreased,but the ability of self-care was improvcd as well.Conclusion The lung volume reduction surgery provides a quite new and effective treatment for some cases of severe chronic obstructive pulmonary disease.