单向活瓣肺减容术在重度慢性阻塞性肺疾病治疗中的应用

Clinical effect and significance of unidirectional valve lung volume reduction in treatment of severe chronic obstructive pulmonary disease

目的探讨单向活瓣肺减容术治疗重度慢性阻塞性肺疾病的应用价值。方法选取2014年1月——2020年1月在郑州大学第二附属医院确诊为重度慢性阻塞性肺疾病并行肺减容术的30例患者作为研究对象。分别对术前、术后1、3、6、12个月肺功能、血气分析、SGRQ生活质量评分、6分钟步行距离(6MWD)等指标进行收集、分析、归纳,并通过重复测量方差分析比较各时间点之间差异。结果术后1、3、6、12个月肺功能、血气分析、SGRQ、6MWD指标改善均优于术前,差异有统计学意义(P<0.05)。术后6个月肺功能、血气分析、SGRQ、6MWD:FEV_(1)(+151mL)、DLCO(+0.942)、RV(-104mL)、PaCO_(2)(-16.58)、PaO_(2)(+14.86)、症状(-7.14分)、活动(-6.4分)、影响(-21.89分)、6MWD(+81.6米);术后1年肺功能、血气分析、SGRQ、6MWD:FEV_(1)(+175mL)、DLCO(+1.545)、RV(-105mL)、症状(-10.32分)、活动(-10.15分)、影响(-26.6分)、6MWD(+99.6米)。结论应用单向活瓣肺减容术治疗重度慢性阻塞性肺疾病可改善患者的症状,提高生活质量,值得进一步继续推广。

Objective To investigate the clinical effect and significance of one-way valve lung volume reduction in patients with severe chronic obstructive pulmonary disease.Methods 30 patients who were diagnosed with severe chronic obstructive pulmonary disease in the Second Affiliated Hospital of Zhengzhou University from January 2014 to January 2020 were selected as the research objects.Their preoperative and postoperative pulmonary function,blood gas analysis,SGRQ quality of life score,6-minute walk test,hemodynamics and other indicators were collected and analyzed.Through repeated measures analysis of variance,the differences among different time points were compared.Results 1,3,6,12 months after surgery,blood gas analysis,SGRQ and 6MWD indicators were better than preoperative,and there was statistical significance(P<0.05).6 months after surgery,blood gas analysis,SGRQ and 6MWD showed that Fev1(+151 mL),DLCO(+0.942),RV(-104 mL),PACO_(2)(-16.58),PAO_(2)(+14.86),Symptoms(-7.14 points),Activity(-6.4 points),effect(-21.89 points),and 6MWD(+81.6 m).1 year after surgery,blood gas analysis,SGRQ and 6MWD showed that Fev1(+175mL),DLCO(+1.545),RV(-105 mL),symptoms(-10.32 points),activity(-10.15),effect(-26.6 points),and 6MWD(+99.6 m).Conclusion The application of one-way vaporiculosity treatment for severe COPD can improve the symptoms of patients and the quality of life,which deserves further continued promotion.