涤纶垫片在肺减容术中的临床应用

Clinical Application of Pieces of Polyester Fibre In Lung Volume Reduction Surgery

目的:探讨涤纶垫片在肺减容术治疗肺气肿中防止肺切缘漏气的临床疗效及外科处理方法。方法:2005年5月16日～2008年12月28日期间收治32例肺气肿病人,其中重度肺气肿10例,中度肺气肿22例,均为双侧肺气肿,17例以右上叶为重,15例以左上叶为重,均伴有大小不等的肺大疱,最大直径为5cm。全组病人在全麻下施行肺减容术,均为单侧。为控制肺切缘漏气,缝合时采用涤纶垫片加固肺气切缘,防止切缘缝线处的肺组织因肺复张易于撕裂而产生严重漏气,同时针眼处涂抹医用生物胶。结果:无手术死亡,术后恢复顺利,其中3例术后漏气2 d,均痊愈出院。随访4～43个月,平均11个月,病人气急好转,活动能力及生活质量提高,无排斥反应。结论:在肺减容术治疗肺气肿中,采用涤纶垫片和医用生物胶防止肺切缘漏气疗效肯定。

Objective： Explore polyester gaskets in lung capacity reduction in surgical treatment to prevent pulmonary emphysema the cut edge a flat clinical efficacy and surgical treatment method. Methods： May 16, 2005 - December 28, 2008, 32 cases of patients were emphysema, Among them, 10 cases of severe emphysema, Peace in obvious shortness of breath , Typical chest barrel shaped, Lung liver Olympics in the eighth costal mar- gin, 3 cm in the lungs activity below, Moderate emphysema 22 cases, Peace in mild shortness of breath, Labor or a little activity the apparent shortness of breath, Rib clearance broadens, Lung liver Olympics in the seventh costal margin, The bottom of the lungs activity in 3--4 cm between. Are all bilateral emphysema, 17 cases to the leaf as the priority, 15 cases to the upper left put the leaves, With all the lung buUous vary in size, The biggest for 5 cm in diameter. All the groups of patients under general anesthesia and reduce the lung capacity of. Are unilateral. To control the lungs the cut edge got a flat, The polyester gaskets when sewing strengthening lung gas cutting edge, To prevent the cut edge suture place the lung tissue of lung after a easy to tear and have a serious leakage, At the same time a needle place daub biomedical glue. Results： No operative death, Postoper- ative recover smoothly, Three cases leak after 2 days, Were recovered discharge, Follow- up 4- 43 months, average 11 months, patients get better short of breath, activity and the ability to improve quality of life. Conclu- sions： In the lung capacity reduction surgical treatment emphysema, The polyester gasket and biomedical glue to prevent lung the cut edge effect must leak.