36例小切口结扎式单肺减容治疗重症COPD

Observation of Lung Volume Reduction Surgeny with Ligation of Mini-incision on COPD

目的探讨并评价以结扎式单肺减容过度气肿肺组织替代传统单肺切割式减容术治疗重度慢性阻塞性肺疾病的可行性、疗效、手术指征、手术要点及术后主要并发症肺漏气的预防和治疗。方法回顾性分析1999年4月-2006年5月两院以结扎式切割过度气肿肺组织替代传统单肺减容治疗的36例重度COPD的随访资料。结果36例病人手术后11-25d康复出院。术后病人的呼吸困难、活动能力及生活质量明显改善,其中6例出现肺漏气,12例出现肺部感染,经治疗后痊愈,无手术死亡。结论以小切口结扎式切割过度气肿肺组织替代传统单肺减容术可以明显改善具有手术适应证COPD患者的临床症状和生理状态,且术后主要并发症肺创面持续漏气明显降低(P<0.01)。

Objective To evaluate the operative possibility, indication, key points, the prevention of air leakage, the main postoperative complication,of resection of overinflated pulmonary tissue by ligation with mini-incision instead of traditional lung volume reduction surgcry. Methods 36 patients from April. 1994 to May 2006 with severe chronic obstructive pulmonary diseases undergoing resection of overinflated pulmonary tissue by ligation with mini-incision instead of traditional LVRS were retrospectively analysed and followed up. Results All the 36 patients had been discharged to rehabilitation and the hospitalization time were 11-25 days. The postoperative dyspenea, mobility, quality of life were evidently alleviated. Of them,6 had air leakage, 12 had pulmonary infection. They left hospital after recovery. There was no operative death. Conclusion The resection of overinflated pulmonary tissue by ligation with mini-incision instead of traditional LVRS provided significantly clinical and physiological improvement for patients with severe chronic obstructive pulmonary diseases. It can reduce the main complication such as the air leakage of lung（P〈 0.01 ）.