AU - Wilkens, H AU - Demertzis, S AU - Konig, J AU - Leitnaker, CK AU - Schafers, HJ AU - Sybrecht，GW TI -肺减容手术与保守治疗严重的肺气肿DP - 2000年12月01 TA -欧洲呼吸杂志》第六PG - 1043 - 1049 - 16 IP - 6 4099 - //www.qdcxjkg.com/content/16/6/1043.short 4100 - //www.qdcxjkg.com/content/16/6/1043.full所以欧元和J2000 12月01;AB -肺减容手术(LVRS)已被建议用于严重肺气肿患者，以改善呼吸困难和肺功能。然而，与保守治疗相比，这些患者的预后和肺功能是否能得到改善尚不清楚。对57例符合LVRS标准的肺气肿患者进行LVRS与保守治疗的前瞻性比较。病人根据自己的决定被分为两组。第1组患者(n=29, 8名女性，平均+/-SEM 58.8+/-1.7年，1秒用力呼气量(FEV1) 27.6+/-1.3%的预测值)行LVRS。2组患者(n=28, 5名女性，58.5+/-1.8岁，FEV1 30.8+/-1.4% pred)首选推迟LVRS。两组患者基线时肺功能无显著差异;然而，在对照组中有更好的功能状态的趋势。 The control group had a better modified Medical Research Council (MMRC) dyspnea score (3.1+/-0.15 versus 3.5+/-0.1, p<0.04). Model-based comparisons were used to estimate the differences between the two groups over 18 months. 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.