经纤维支气管镜治疗慢性阻塞性肺疾病研究进展

Bronchoscope procedures for chronic obstructive pulmonary disease

目前治疗慢性阻塞性肺疾病（COPD）的方法以药物治疗为核心,包括戒烟、肺康复训练、使用支气管扩张剂,必要时使用激素和氧疗。在近10年随着外科治疗的不断进展。美国肺气肿治疗试验研究结果显示外科肺减容术（LVRS）可以达到缓解COPD患者呼吸困难症状,提高患者生活质量。因此而出现各种研究试图替代LVRS,以减少LVRS的并发症。其中经纤维支气管镜LRVS目前研究较多,这种方法将来可能会占重要地位。特别是经纤维支气管镜单向活瓣支架LVRS和气道旁路已经进入临床研究阶段。

Medical treatment is the mainstay of therapy of chronic obstructive pulmonary disease （COPD）, consisting of smoking cessation, pulmonary rehabilitation, administration of bronchodilators and, when indicated,steroids and supplemental oxygen. Various surgical procedures have been promoted in recent ten years,American of NETT findings is lung volume reduction surgery（LVRS） may relieve dyspnoea and improve quality of life in the patients with advanced emphysema. It have stimulated a range of innovtive alternative ideas,aiming at improving outcomes and reducing complications associated with current LVRS techniques. Bronchoscopic alternatives to LVRS have been recently proposed and some may play an important role in the future;in particular, the airway bypass and bronchoscopic LVRS with one-way valves are certainly one step beyond on their way to clinical application. Hereby, the paper reports the initial experimental and clinical experience with these new treatment options.