【摘要】 目的　探讨肺减容术治疗重度肺气肿的临床效果。方法　 1997年 10月至 2 0 0 3年 3月期间 2 3例重度肺气肿患者在胸腔镜辅助微创下施行肺减容术 ,其中单侧 13例 ,分期双侧 10例。用直线切割缝合器和内镜切割缝合器衬垫牛心包 ,切除一侧肺容积为 3 0 %。结果　本组无手术死亡。 1例并发急性呼吸衰竭 ,5例肺持续漏气。术后半年 ,FEV1和PaO2 平均增加 3 0 6%和 15 4% ,TLC和RV降低 2 1 7%和 3 5 4% ,6min步行距离增加 15 8m左右。与单侧LVRS相比 ,分期双侧LVRS的临床指标进一步改善。结论　肺减容术作为一种姑息性手术 ,对选择性重度肺气肿患者 ,能够改善其呼吸功能 ,增加活动能力以及缓解临床症状更多还原

【Abstract】 Objective To evalute the clinical results of lung volume reduction surgery(LVRS) for patients with severe emphysema. Methods Clinical material and methods From October 1997 to March 2003,23 patients with severe emphysema underwent LVRS. The LVRS was performed for 23 patients through thoracoscope assisted thoracic minimal invasive surgery,including unilaterally in 13 and bilaterally in 10 by stages. Approximately 30% of the total volume of each lung was excised using linear stapler and Endo-GIA reinformed bovine pericardial strips to buttress the staple line of lung resected margin. Results There was no operative death. Postoperative complications included acute respiratory failure in 1 and lung persistent airleak in 5. Half a year after surgery,the mean forced expiratory volume in 1 second(FEV 1) and PaO 2were significantly increased by 30.6% and 15.4%,respectively. Total lung capacity(TLC) and residual volume(RV) were markedly decreased by 21.7% and 35.4%,respectively. Six minute walk test was significantly increased by 158 metre. There was further improvement in bilaterally in 10 by stages. Conclusion In selected patients with severe emphysema,LVRS as a palliative therapy can improve respiratory function,walking distance and symptomatic relief.更多还原