肺减容手术(LVRS)治疗重度阻塞性肺气肿

Lung volume reduction surgery(LVRS)for treating the severe obstructive emphysema

目的探讨重度肺气肿采用肺减容术的适应症、围手术期准备及手术方法。方法对6例重度肺气肿患者施行肺容积减少术,其中同期双侧2例,单侧4例。为控制肺切面漏气,缝合时衬以牛心包片。本组切除一侧肺容积25%～30%。结果无手术死亡。术后2例并发急性呼吸衰竭,经积极抢救处理而治愈。术后随诊3～12个月,肺功能有明显改善,PaO2均有显著上升,PaCO2亦有所下降。结论肺减容术是治疗严重肺气肿的有价值的治疗方法之一。

Objective To investigate the operation indication,perioperative preparation and operative methods of LVRS for severe obstructive pulmonary emphysema. Methods 6 cases with severe pulmonary emphysema underwent the LVRS.Among them,the bilateral LVRS were performed in 3 cases.and unilateral LVRS was in 4 cases.For controlling the air learkage of pulmonary section,the bovine pericardium was used as a lining during the suture time.Resected unilateral lung volume was 25% to 30%. Results There was no operative death. Postoperative acute respiratory failure was found in 2 patients. Via active rescued management,the 2 cases were cured.All patients were followed up for 3 to 12 months.The pulmonary functions were improved obviously.Postoperative PaO2 was increased and PaCO2 was decreased.Conclusion LVRS is one of effective therapeutic method in the treatment of severe obstructive pulmonary emphysema.