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首页> 外文期刊>Respiratory care >Bronchoscopic lung volume reduction for pulmonary emphysema:Preliminary experience with endobronchial occluder
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Bronchoscopic lung volume reduction for pulmonary emphysema:Preliminary experience with endobronchial occluder

机译：支气管镜减少肺气肿的肺容量：支气管内封堵器的初步经验

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OBJECTIVE: To describe the self-expanding endobronchial occluder, as utilized in bronchoscopic lung volume reduction, with a 36 month follow-up procedure. METHODS: Twenty-three subjects with severe emphysema were recruited and underwent flexible bronchoscopic placement of selfexpanding endobronchial occluders. Outcomes were assessed at 1 week, 1-month, 3-, 6-, 12-, 24-, and 36-month intervals. Feasibility, safety, and efficacy were analyzed by means of pulmonary function testing, 6-min walk test, dyspnea score, BODE (body mass index, air-flow obstruction, dyspnea, and exercise capacity) index, and St George's Respiratory Questionnaire. RESULTS: Fifty-eight self-expanding endobronchial occluders were implanted into 23 lobes previously selected. No displacement was found during the follow-up. Five subjects experienced postoperative complications of cough, and 6 subjects had lobar pneumonia, which were not located in any of the blocked segments. The FEV1 in 18 subjects was improved by 15%, compared with baselines (P .001), and the mean first efficacy time and maximal efficacy time were 5.65 ± 1.51 months and 6.35 ± 3.08 months, respectively. No significant changes were observed in FVC or the ratio of residual volume to TLC. The 6-min walk distance, dyspnea score, and St George's Respiratory Questionnaire total score were improved in 22 subjects over a 24-month period, and a minority of subjects continued to improve through to the end of the study. Mean baseline BODE index had improved during follow-up, but not at the study's conclusion. CONCLUSIONS: This preliminary study demonstrates early significant improvements in pulmonary function, 6-min walk distance, dyspnea score, BODE index, and quality of life after placement of the self-expanding endobronchial occluder in bronchoscopic lung volume reduction. Its placement also proved both easy and safe. However, the initial improvements were maintained long-term for only a minority of subjects.
机译：目的：描述用于支气管镜减少肺体积的自扩张支气管内封堵器，并进行36个月的随访。方法：招募了23名严重肺气肿患者，并对其进行了柔性支气管镜置入自扩张支气管内封堵器。每隔1周，1个月，3、6、12、24和36个月评估结果。通过肺功能测试，6分钟步行测试，呼吸困难评分，BODE（体重指数，气流阻塞，呼吸困难和运动能力）指数和圣乔治呼吸问卷调查分析了可行性，安全性和有效性。结果：58个自扩张支气管内封堵器被植入到先前选择的23个叶中。随访期间未发现移位。五名受试者发生了术后咳嗽并发症，而六名受试者患有大叶性肺炎，其不在任何阻塞的部位。与基线相比，18名受试者的FEV1改善了> 15％（P <.001），平均首次疗效时间和最大疗效时间分别为5.65±1.51个月和6.35±3.08个月。 FVC或残留体积与TLC的比率均未观察到明显变化。在24个月内，对22位受试者的6分钟步行距离，呼吸困难评分和圣乔治呼吸问卷的总评分均有所改善，并且少数受试者在研究结束之前一直持续改善。随访期间平均基线BODE指数有所改善，但研究结论并未改善。结论：这项初步研究表明，自扩张支气管内封堵器放置在支气管镜下肺容积减少后，肺功能，6分钟步行距离，呼吸困难评分，BODE指数和生活质量有早期显着改善。它的放置也被证明既简单又安全。但是，只有少数受试者可以长期保持最初的改善。

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