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首页> 外文期刊>Thorax: The Journal of the British Thoracic Society >Altered thoracic gas compression contributes to improvement in spirometry with lung volume reduction surgery.
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Altered thoracic gas compression contributes to improvement in spirometry with lung volume reduction surgery.

机译：改变胸廓气体压缩有助于减少肺体积，从而改善肺活量。

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BACKGROUND: Thoracic gas compression (TGC) exerts a negative effect on forced expiratory flow. Lung resistance, effort during a forced expiratory manoeuvre, and absolute lung volume influence TGC. Lung volume reduction surgery (LVRS) reduces lung resistance and absolute lung volume. LVRS may therefore reduce TGC, and such a reduction might explain in part the improvement in forced expiratory flow with the surgery. A study was conducted to determine the effect of LVRS on TGC and the extent to which reduced TGC contributed to an improvement in forced expiratory volume in 1 second (FEV(1)) following LVRS. METHODS: The effect of LVRS on TGC was studied using prospectively collected lung mechanics data from 27 subjects with severe emphysema. Several parameters including FEV(1), expiratory and inspiratory lung resistance (Rle and Rli), and lung volumes were measured at baseline and 6 months after surgery. Effort during the forced manoeuvre was measured using transpulmonary pressure. A novel method was used to estimate FEV(1) corrected for the effect of TGC. RESULTS: At baseline the FEV(1) corrected for gas compression (NFEV(1)) was significantly higher than FEV(1) (p<0.0001). FEV(1) increased significantly from baseline (p<0.005) while NFEV(1) did not change following surgery (p>0.15). TGC decreased significantly with LVRS (p<0.05). Rle and maximum transpulmonary pressure (TP(peak)) during the forced manoeuvre significantly predicted the reduction in TGC following the surgery (Rle: p<0.01; TP(peak): p<0.0001; adjusted R(2) = 0.68). The improvement in FEV(1) was associated with the reduction in TGC after surgery (p<0.0001, adjusted R(2) = 0.58). CONCLUSIONS: LVRS decreased TGC by improving expiratory flow limitation. In turn, the reduction in TGC decreased its negative effect on expiratory flow and therefore explained, in part, the improvement in FEV(1) with LVRS in this cohort.
机译：背景：胸腔气体压缩（TGC）对强制性呼气气流产生负面影响。肺阻力，强制性呼气动作中的努力以及绝对肺容量都会影响TGC。减少肺体积手术（LVRS）可减少肺阻力和绝对肺体积。因此，LVRS可能会减少TGC，而这种减少可能部分解释了手术后强制呼气流量的改善。进行了一项研究，以确定LVRS对TGC的影响以及TGRS降低导致LVRS后1秒内强制呼气量改善的程度（FEV（1））。方法：使用前瞻性收集的来自27名严重肺气肿患者的肺力学数据，研究了LVRS对TGC的影响。在基线和术后6个月测量了一些参数，包括FEV（1），呼气和吸气肺阻力（Rle和Rli）以及肺容量。使用跨肺压力来测量强迫动作期间的努力。一种新的方法被用来估计为TGC的影响校正的FEV（1）。结果：在基线时，经气体压缩校正的FEV（1）（NFEV（1））明显高于FEV（1）（p <0.0001）。 FEV（1）从基线开始显着增加（p <0.005），而NFEV（1）在手术后没有变化（p> 0.15）。 LVRS使TGC显着降低（p <0.05）。 Rle和强制性操作过程中的最大经肺压力（TP（peak））显着预测了手术后TGC的降低（Rle：p <0.01; TP（peak）：p <0.0001;调整后的R（2）= 0.68）。 FEV（1）的改善与手术后TGC的减少有关（p <0.0001，调整后的R（2）= 0.58）。结论：LVRS通过改善呼气流量限制降低了TGC。反过来，TGC的减少减少了其对呼气流量的负面影响，因此部分解释了该队列中LVRS对FEV（1）的改善。

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