抽象
已经提出了肺粪池减少手术（LVRS）为严重肺气肿的患者提高呼吸困难和肺功能。然而，与保守治疗相比，这些患者的预后和肺功能是未知的。在57例肺气肿患者中预先实现了LVRS和保守疗法的影响，他满足了LVRS的标准标准。根据自己的决定，患者分为两组。第1族患者（n = 29,29,女性，平均值+/-SEM 58.8 +/- 1.7 YRS，强制呼气量在一秒内（FEV1）27.6 +/- 1.3％的预测值）接受了LVRS。第2组患者（n = 28,5例，女性，58.5 +/- 1.8 YRS，FEV1 30.8 +/- 1.4％pred）优选推迟LVR。基线两组之间的肺功能没有显着差异;但是，对照组中存在更好的功能状态。该对照组有更好的修改医学研究委员会（MMRC）呼吸困难评分（3.1 +/- 0.15与3.5 +/- 0.1，P <0.04）。基于模型的比较用于估计两组超过18个月的两组之间的差异。 Significant improvements were observed in the LVRS group compared to the control group in FEV1, total lung capacity (TLC), Residual volume (RV), MMRC dyspnea score and 6-min walking distance on all follow up visits. The estimated difference in FEV1 was 33% (95% confidence interval 13-58%; p>0.0001), in TLC 12.9% (7.9-18.8%; p>0.0001), in RV 60.9% 32.6-89.2%; p>0.0001), in 6-min walking distance 230 m (138-322 m; p<0.002) and in MMRC dyspnoea score 1.17 (0.79-1.55; p<0.0001). In conclusion, lung volume reduction surgery is more effective than conservative treatment for the improvement of dyspnoea, lung function and exercise capacity in selected patients with severe emphysema.
