肺减容术治疗重度肺气肿12例疗效分析

目的 评价肺减容术(LVRS)治疗重度肺气肿的中长期疗效、手术指征选择及围术期处理经验。方法 回顾性分析1997年7月至2002年6月，12例重度肺气肿病人施行肺减容术的随访资料，双侧肺减容术2例，单侧肺减容术8例。胸腔镜肺减容术2例。术前第1秒用力呼气量(FEV。)平均0．89L，气急指数2．40。结果 双侧LVRS术后FEV1平均提高50％，单侧LVRS术后FEV1平均提高仅32％。术后6～12个月，FEV1改善达高峰。手术死亡率0%，术后并发症发生率60．8％。结论 肺减容术能明显改善部分具有手术适应证的重度肺气肿病人的临床症状和生理状况。

Functional results of lung volume reduction surgery in 12 patients with severe emphysema

Objective To evaluate the mid-long term outcom of lung volume reduction surgery(LVRS)in patients with severe emphysema.Methods The follow-up date of 12 patients with severe emphysema underwent LVRS were analyzed retrospectively between July 1997 to June 2002.The LVRS was performed bilaterally in 2 patients through median stemotomy or bilaterally anterolateral thoracotomy,unilaterally in 2 via posterlateral thoracotomy and in 2 via VATS.Baseline functional tests were as follows,mean FEV 1=0.89 L,mean postoperative FEV1 increased by 50% in bilateral LVRS over 32% in unilat-eral LVRS.exercise tolerance and lung function between 6 months to 1 years.The hospital mortality rate was 0%.The postoperative complicatio incidence was 60.8%.Conclusion LVRS provides significant clinical and physiological improvement for the majority of patients in a subset of patients with severe emphysema.