Bronchoscopic Lung Volume Reduction For Pulmonary Emphysema: Preliminary Experience With Endobronchial Occluder
Bronchoscopic Lung Volume Reduction For Pulmonary Emphysema: Preliminary Experience With Endobronchial Occluder
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支气管镜肺减容术治疗肺气肿：支气管内封堵器的初步经验
DOI：
10.4187/respcare.02218
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发表时间：
2013-08
期刊：
影响因子：
2.5
通讯作者：
Li, Yan
中科院分区：
文献类型：
--
作者：
Song, Liqiang;Zhao, Feng;Ti, Xinyu;Chen, Weiqiang;Wang, Gaowen;Wu, Changgui;Li, Yan
目的：描述自膨式支气管内封堵器在支气管镜肺减容术中的应用以及36个月随访手术。方法：招募了23例重度肺气肿受试者，并接受了自膨式支气管内封堵器的柔性支气管镜置入。在1周、1个月、3个月、6个月、12个月、24个月和36个月时评估结局。通过肺功能检查、6分钟步行试验、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St乔治呼吸问卷分析可行性、安全性和有效性。结果：将58个自膨式支气管内封堵器植入先前选择的23个肺叶。随访期间未发现移位。5例受试者发生咳嗽等术后并发症，6例受试者发生大叶性肺炎，均不位于任何阻塞节段。18例患者FEV 1较基线改善> 15%（P <0.001），平均首次起效时间为5.65 ± 1.51个月，平均最大起效时间为6.35 ± 3.08个月。FVC或残气量与TLC的比值未观察到显著变化。在24个月期间，22例受试者的6分钟步行距离、呼吸困难评分和St乔治呼吸问卷总分均有所改善，少数受试者持续改善至研究结束。平均基线BODE指数在随访期间有所改善，但在研究结束时没有改善。结论：这项初步研究表明，在支气管镜肺减容术中置入自膨式支气管内封堵器后，肺功能、6分钟步行距离、呼吸困难评分、BODE指数和生活质量均得到早期显著改善。它的放置也证明既容易又安全。然而，只有少数受试者的初始改善得以长期维持。
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 self-expanding 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.
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DOI：
10.1111/j.1745-7599.2011.00602.x
发表时间：
2011-04
影响因子：
--
作者：
C. Downs
通讯作者：
C. Downs
DOI：
10.1513/pats.200707-085et
发表时间：
2008-05
期刊：
Proceedings of the American Thoracic Society
影响因子：
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作者：
E. Ingenito;D. Wood;J. Utz
通讯作者：
E. Ingenito;D. Wood;J. Utz
影响因子：
6.9
作者：
S. Kotecha;G. Westall;L. Holsworth;A. Pham;T. Williams;G. Snell
通讯作者：
S. Kotecha;G. Westall;L. Holsworth;A. Pham;T. Williams;G. Snell
DOI：
10.1164/ajrccm.163.5.2101039
发表时间：
2001-04
影响因子：
24.7
作者：
R. Pauwels;A. Buist;P. Calverley;C. Jenkins;S. Hurd
通讯作者：
R. Pauwels;A. Buist;P. Calverley;C. Jenkins;S. Hurd
DOI：
10.1097/00128594-200307000-00024
发表时间：
2007
期刊：
--
影响因子：
--
作者：
F. Venuta;E. Rendina;T. Giacomo;G. Coloni
通讯作者：
F. Venuta;E. Rendina;T. Giacomo;G. Coloni