国产缝合器在肺气肿肺减容术中的应用

The Application of Homemade Anastomotic Machine in Lung Volume Reduction Surgery for Emphysema

目的总结 8例重度肺气肿病人用国产缝合器行肺减容术的治疗经验。方法 8例重度肺气肿 ,1例伴基础病食管癌 ,7例经胸经胸骨正中切口行双侧肺减容 ,1例在食管癌根治术同时行左肺减容。均采用常州XF90缝合器衬以自体肺组织片。切除一侧肺容积 2 0 %～ 30 %。结果 7例痊愈 ,1例术后漏气 8天自愈。随访 1年 ,病人症状 ,肺功能改善 (P <0 0 0 1) ,气急指数从Ⅳ～Ⅴ级转变为Ⅰ～Ⅲ。PaO2 平均上升 18 2mmHg ,6MWT从 (180 6± 36 2 )m增至 (5 18± 2 5 1)m(x±S)。结论用国产缝合器行肺减容术 ,既节省医疗费用 ,又使各项指标改善 ,无并发症 。

Objective To summarize the treatment experience of lungvvolume reduction surgery (LVRS) with homemade anastomotic machine for 8 patients suffered sever emphysema. Methods one of eight patients was accompanied with cancer of esophagus and performed LVRS of left lung addition to the radical surgery of cancer of esophagus through left thorax. Seven patients were performed two sides LVRS through sternum precise middle incision. XF90 anastomotic machine and autogenous lung tissue were used. Twenty to thirty percents of lung volume of each side were resected. Results: Seven patients were cured, one leaked air postoperatively, and recovered by himself 8 days later. The great improvement of their symptoms and lung functions were observed by one-year-long follow-up (P<0.001). The index of dyspnea were improved from Ⅳ-Ⅴ degree to Ⅰ-Ⅲ degree. The PaO2 was going up to 18.2mmHg averagely. 6MWT was increased from 180.6±36.2m to 518±25.1m(x±Sx). Conclusion: It is an appropriate method to use homemade anastomotic machine in LVRS, which is economical and has no complications.