| 沈青,吴丽君,徐炜,刘琦,朱占英,陈清勇.经支气管镜单向活瓣肺减容术治疗巨大肺大疱的疗效分析[J].浙江中西医结合杂志,2026,36(4): |
| 经支气管镜单向活瓣肺减容术治疗巨大肺大疱的疗效分析 |
| Efficacy of bronchoscopic lung volumere reduction in the treating of Giant Pulmonary Bullae |
| 投稿时间：2025-06-24 修订日期：2026-02-13 |
| DOI： |
| 中文关键词: 巨大肺大疱 支气管镜下单向活瓣 肺功能 定量CT分析 并发症 |
| 英文关键词:Giant pulmonary bulla Endobronchial valve Pulmonary function quantitative CT analysis Complications |
| 基金项目:浙江省医药卫生科技项目(2022KY283) |
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| 中文摘要: |
| 目的:探讨经支气管镜引导置入单向活瓣在巨大肺大疱患者中的临床疗效、并发症及其远期影响。方法:选取我院2020年4月-2024年5月期间患有巨大肺大疱的15例患者作为研究对象,收集患者的一般资料,排除禁忌症后均行支气管镜下单向活瓣置入术,患者术前和术后1、3、12个月分别行胸部高分辨率计算机断层扫描(high resolution CT,HRCT)、肺功能、6分钟步行距离 (6-minute walk distance,6MWD)、慢性阻塞性肺病CAT(COPD Assessment Test)评分、血气并对上述结果进行分析,进一步观察活瓣置入后短期或长期并发症、临床疗效、安全性。结果:与术前相比,术后随访患者的临床症状得到改善,定量CT分析肺大疱的体积缩小,肺功能第1秒用力呼气容积(FEV1)、FEV1占用力肺活量(FVC)的百分比(FEV1/FVC%)、CAT评分、6MWD有不同程度的改善、血气中二氧化碳分压较前下降。常见手术并发症为痰栓、瓣膜开合欠佳、气胸、肉芽、感染,观察期内,未见操作及活瓣相关死亡。结论:巨大肺大疱患者行支气管镜下单向活瓣肺减容对患者肺大疱体积、肺功能、活动耐量均有改善,并发症如气胸、痰栓、肉芽经治疗后不影响EBV的疗效。 |
| 英文摘要: |
| Objective: To investigate the clinical efficacy, complications, and long-term impact of Bronchoscopic lung volume reduction with endobronchial valve in patients with giant pulmonary bullae.Methods: 15 patients with giant pulmonary bullae admitted to our hospital between April 2020 and May 2024 were enrolled as the study subjects. After collecting general patient data and excluding contraindications, all patients underwent bronchoscopic EBV placement. Assessments were performed preoperatively and at 1, 3, and 12 months postoperatively. These included chest high-resolution computed tomography (HRCT), pulmonary function tests [including Forced Expiratory Volume in 1 second (FEV1) and the ratio of FEV1 to Forced Vital Capacity (FVC) (FEV1/FVC%)], 6-minute walk distance (6MWD), COPD Assessment Test (CAT) score, and arterial blood gas analysis. The results of these assessments were analyzed. Short-term and long-term complications, clinical efficacy, and safety following valve placement were further observed.Results: Compared to preoperative values, follow-up examinations showed the clinical symptoms of patients were improved,quantitative CT analysis revealed a reduction in bullae volume. Pulmonary function parameters (FEV1, FEV1/FVC%), CAT scores, and 6MWD demonstrated varying degrees of improvement. Arterial partial pressure of carbon dioxide (PaCO2) decreased significantly. Common procedure-related complications included mucus plugging, suboptimal valve opening/closing, pneumothorax, granulation tissue formation, and infection. No procedure- or valve-related mortality occurred during the observation period.Conclusion:The bronchoscopic lung volume reduction with endobronchial valve in patients with giant pulmonary bullae were improved bullae volume, pulmonary function, and exercise tolerance. Complications such as pneumothorax, mucus plugging, and granulation tissue, when treated appropriately, did not affect the efficacy of EBV therapy. |
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