重度肺气肿肺减容手术治疗效果观察

Effect observation of lung volume reduction surgery in treatment of severe pulmonary emphysema

目的探讨肺减容手术对重度肺气肿患者的临床疗效。方法选取2009年3月～2010年10月在本院收治的重度肺气肿患者23例,手术指标按照ATS标准确定,本组患者行单侧肺减容手术15例,双侧肺减容手术8例。结果术后23例患者均痊愈出院,且在术后第2天便可下床进行活动,术后肺平均漏气时间为2.5d。所有患者的胸闷、呼吸困难情况有不同程度的缓解或消失。动脉血氧分压与二氧化碳分压均比术前差异具有统计学意义(P<0.05)。术后肺功能:FEV1、6-MWD比术前有明显改善(P<0.01),RV、TLC较术前有明显降低(P<0.01),差异具有统计学意义。结论总之,肺减容手术能够有效改善肺功能,提高动脉血氧分压,降低二氧化碳分压,使患者的胸闷、呼吸困难情况有不同程度的缓解或消失,缩短术后恢复时间,减少疼痛,具有临床推广价值。

Objective To investigate the effect of lung volume reduction surgery in treatment of severe pulmonary emphysema.Methods Twenty-three cases of patients with severe emphysema in our hospital from March 2009 to October 2010 were selected,surgery index was formulated with the ATS standards,15 cases were given unilateral lung volume reduction surgery,8 cases were given bilateral lung volume reduction surgery.Results Twenty-three patients all recovered and discharged postoperative,and all could taken activities in 2 days after surgery,the average time for lung leakage was 2.5 days.The chest tightness,breathing difficulties of patients eased in different degrees or disappeared.Blood oxygen partial pressure and carbon dioxide pressure were improved than before,the difference was statistically significant （P 0.05）.Postoperative lung function：FEV1,6-MWD were improved obviously than before（P 0.01）,RV,TLC were reduced significantly than before （P 0.01）,the difference were all statistically significant.Conclusion In a word,lung volume reduction surgery can effectively improve lung function,improve the arterial oxygen partial pressure,reducing carbon dioxide pressure,ease the chest tightness,breathing difficulties effectively,shorten postoperative recovery time,reduce the pain,so it has clinical application value.