【摘要】 目的探讨国产闭合器和自体材料在肺减容术中的应用效果。方法2000年6月～2006年3月,行肺减容术13例,均为男性,年龄56～68岁,平均60.5岁。肺气肿病史2～16年,平均11年。全麻下气管插管,单肺通气,行不断胸肌切口,经第5肋间进胸,经肉眼观察及手触摸,结合CT检查,确定靶区。肺切缘残端用自体组织垫片和国产闭合器行肺减容术。结果手术全部成功,随访8个月～5年,呼吸困难症状改善,活动耐力提高。术后6个月肺功能第1秒时间肺活量(FEV1)增加94.4%±21.2%,动脉血氧分压上升12.5%±3.1%。残气量(RV)和肺总量(TLC)分别下降24.1%±7.8%和20.8%±5.1%。上述各项指标术前与术后相比差异均有统计学意义(P<0.05)。结论国产闭合器和自体组织垫片在肺减容术中效果肯定。更多还原

【Abstract】 Objective To evaluate the results of lung volume reduction surgery （LVRS） using domestic staplers and autologous tissue. Methods Thirteen male patients received LVRS from June 2000 to March 2006 in this hospital. The age range was 56⁶8 years （mean, 60.5 years）. The patients had a history of chronic obstructive pulmonary disease （COPD） for 2¹6 years （mean, 11 years）. The operation was performed under general anesthesia, with single lung ventilation. A muscle sparing thoracotomy in the 5th intercostal space was conducted. The “target area” was identified by combination of observation and palpation during operation and preoperative CT scans. The cutting edge was stapled with domestic staplers buttressed with autologous tissue. Results All the procedures were successfully accomplished. Follow-up observations for 8 months 5 years showed no dyspnea and improved activities. At 6 months after operation, the FEV₁ and the PaO₂ were increased by 94.4%±21.2% and 12.5%±3.1%, while the RV and TLC were decreased by 24.1%±7.8% and 20.8%±5.1%, respectively. All the abovementioned parameters were significantly changed before and after operation （P<0.05）. Conclusions Lung volume reduction surgery using domestic staplers and autologous tissue gives favorable results.更多还原