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find Keyword "慢性阻塞性肺气肿" 4 results
  • 电视胸腔镜双侧肺减容术21例

    目的 总结电视胸腔镜双侧肺减容术(BLVRS)治疗慢性阻塞性肺气肿(COPE)的临床经验,并观察其疗效。 方法 2009年9月至2010年9月,南京医科大学附属南京医院对21例COPE患者行电视胸腔镜 BLVRS,均为男性,年龄(65.71±9.05)岁。采用电视胸腔镜专用切缝器(Endo-GIA)切除过度充气的肺大泡组织,常规用4-0 Prolene线连续往返缝合。术后观察患者的肺功能、血气分析指标和6 min步行距离(6-MWD)的变化,并与术前进行比较,评价手术疗效。 结果 无围术期死亡,术后住院时间(13.20±4.60) d,胸腔引流时间(5.33±3.67) d。术后持续肺漏气 (5.91±3.52) d 12例,出现急性呼吸衰竭1例,广泛皮下气肿2例,合并肺部感染5例,均经相应的处理治愈。随访21例,随访时间6个月,术后6个月第1秒用力呼气容积[(1.63±0.23) L vs. (1.21±0.17) L]、动脉血氧分压[(77.62±6.98) mm Hg vs. (67.54±8.12) mm Hg]和6-MWD [(430.55±80.49) m vs. (283.48±108.12) m]较术前增加,动脉血二氧化碳分压(PaCO2)、、残气量(RV) 较术前降低(P<0.05)。 结论 电视胸腔镜BLVRS安全、有效,特别对非均质性肺气肿,可明显改善患者的生活质量,近期效果显著。

    Release date:2016-08-30 05:50 Export PDF Favorites Scan
  • 肺减容术治疗慢性阻塞性肺气肿

    目的 为了提高肺气肿患者生存质量,探讨肺减容手术治疗慢性阻塞性肺气肿的可行性. 方法 本组肺减容手术16例,其中同期双侧肺减容手术9例,胸腔镜辅助小切口肺减容术4例,标准后外侧切口单侧肺减容术3例.术前根据计算机体层摄影术(CT)和同位素肺通气肺灌注扫描选择肺气肿手术"靶区",术中使用带牛心包垫的直线型切割缝合器切除病变,防止肺泡漏. 结果 手术时间90~250分钟,平均146分钟;主要并发症有肺泡漏≥7天6例,心房颤动2例,呼吸衰竭1例,术后胸腔内出血1例.13例手术结束即拔出气管内插管,3例带管回病房需要机械通气.随访2~40个月,14例健在,术后患者呼吸困难指数上升为Ⅰ级1例,Ⅱ级10例,Ⅲ级3例. 结论 慢性阻塞性肺气肿选择性手术能改善患者肺功能,长期效果尚需要观察.

    Release date:2016-08-30 06:31 Export PDF Favorites Scan
  • Staged Bilateral Single-port Thoracoscopic Lung Volume Reduction Surgery: A Clinical Analysis

    ObjectiveTo investigate the feasibility and efficacy of staged bilateral single-port thoracoscopic lung volume reduction surgery (LVRS) for the patients with chronic obstructive pulmonary emphysema (COPE). MethodsWe retrospectively analyzed clinical data of eleven male patients with bilateral COPE and bullae in Xuzhou Central Hospital Affiliated to Southeast University from January 2013 through June 2014. All the patients underwent staged bilateral single-port thoracoscopic LVRS with their age of 60.27± 12.11 years. The hyperinflated bullae were resected using endoscopic staplers (Endo-GIA), followed by continuous suture and biological glue for reinforcement of the margin. Besides, the pulmonary function, blood gas assay, 6-minute walk distance (6-MWD), and life quality evaluated by short form 36 Health survey questionnaire (SF-36) were recorded before and after LVRS respectively. ResultsAll the patients survived after surgery. Chest tube drainage time was 9.09± 1.31 days. Postoperative hospital stay was 15.73± 2.75 days. There were 5 patients with persistent air leakage and 7 patients with pulmonary infection who were cured finally. The pulmonary function, arterial partial pressure of oxygen(PaO2), 6-MWD and life quality after unilateral or bilateral LVRS improved than those before surgery in postoperative 3 months. However, there was no statistical difference in outcomes between unilateral and bilateral LVRS patients. ConclusionStaged bilateral single-port thoracoscopic LVRS could improve short-term life quality of patients with COPE.

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  • Analysis of the safety and feasibility of two closed thoracic drainage methods after video-assisted thoracoscopic lung volume reduction surgery

    ObjectiveTo investigate the effects of closed thoracic drainage with single tube or double tubes after video-assisted thoracoscopic lung volume reduction surgery.MethodsRetrospective analysis was performed on 50 patients (39 males, 11 females) who underwent three-port thoracoscopic lung volume reduction surgery in our hospital from January 2013 to March 2019. Twenty-five patients with single indwelling tube after surgery were divided into the observation group and 25 patients with double indwelling tubes were divided into the control group.ResultsThere was no significant difference in pulmonary retension on day 3 after surgery, postoperative complications, the patency rate of drainage tube before extubation, retention time or postoperative hospital stay (P>0.05). Postoperative pain and total amount of nonsteroidal analgesics use in the observation group was less than those in the control group (P<0.05). ConclusionIt is safe and effective to perform closed thoracic drainage with single indwelling tube after video-assisted thoracoscopic lung volume reduction surgery, which can significantly reduce the incidence of related adverse drug reactions and facilitate rapid postoperative rehabilitation with a reduction of postoperative pain and the use of analgesic drugs.

    Release date:2020-06-29 08:13 Export PDF Favorites Scan
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