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目的研究肺减容术对重度肺气肿的手术适应证和临床疗效。方法选择２０例重度肺气肿患者，经胸骨正中劈开切口或电视辅助胸腔镜途径，用直线切割缝合器或ＥｎｄｏＧＩＡ，切除因过度膨胀而破坏的、无功能肺组织。每侧肺切除其容量的２０％～３０％。结果术后呼吸困难明显减轻或消失；９５％患者呼吸困难指数从４～５级转为１～２级。肺功能１秒时间肺活量（ＦＥＶ１）增加４１４％，残气量（ＲＶ）和肺总量（ＴＬＣ）分别下降２７５％和２２７％。动脉血氧分压平均上升１２６ｍｍＨｇ。６分钟步行实验增加５５８％。上述指标术后与术前比均差异有极显著意义（Ｐ＜００１）。８例肺漏气时间延长（＞７天）。１例并发应激性消化道溃疡、出血。本组无围手术期死亡。结论肺减容术是治疗重度肺气肿的新技术和有效治疗方法。
Objective To study the surgical indications and clinical effects of lung volume reduction surgery on severe emphysema. Methods Twenty patients with severe emphysema were selected. The sternal mid split incision or TV-assisted thoracoscopic approach was used. The straight-line stapler or EndoGIA was used to remove the non-functional lung tissue damaged by over-expansion. Each side of the lung to remove its capacity of 20% to 30%. Results The postoperative dyspnea was significantly reduced or disappeared. The index of dyspnea in 95% patients changed from 4 ~ 5 to 1 ~ 2. Pulmonary function increased by 41.4% FEV1, RV and total lung volume by 275% and 227% respectively in one second. Arterial oxygen partial pressure increased by an average of 12 6mmHg. 6-minute walk test increased 55 8%. The above indexes were significantly different between postoperative and preoperative (P <001). 8 cases of leaking lung time (> 7 days). 1 case of concurrent stress peptic ulcer bleeding. This group no perioperative deaths. Conclusions Lung volume reduction is a new technique and effective treatment for severe emphysema.