非输入管与输入管的肺体积减小手术在末期肺缩症和高头症患者
Ali Akil1, Stephanie Rehers2, Stephan Ziegeler2
1Department of Thoracic Surgery and Lung Support, Ibbenbueren General Hospital, 49477 Ibbenbueren, Germany.
Journal of clinical medicine
|June 10, 2023
概括
使用外周麻醉的非输管肺体积减小手术 (LVRS) 对患有高头的肺患者有效. 与传统的直管手术相比,这种方法减少了死亡率,住院时间和并发症.
科学领域:
- 胸部外科手术 胸部外科手术
- 肺部医学 肺部医学
- 麻醉学 麻醉学
背景情况:
- 肺体积减小手术 (LVRS) 是末期肺气的关键治疗方法.
- 在接受LVRS的患者中,手术前的头皮增大带来了重大挑战.
- 为高风险患者优化手术技术对于改善结果至关重要.
研究的目的:
- 为了比较非输入式与输入式LVRS的疗效和安全性.
- 为了评估患有末期肺气和手术前高头症的患者的结果.
- 评估低流动静脉静脉外体肺支 (VV ECLS) 在减轻风险方面的作用.
主要方法:
- 预计将招募92名患有末期肺缩症和头皮增大症的患者.
- 单边视频辅助胸腔镜LVRS (VATS-LVRS) 在外周麻醉下 (非输入管) 与全身麻醉 (输入管).
- 在手术期间在所有患者中应用低流VV ECLS;回顾性数据分析.
主要成果:
- 与静脉注射LVRS (n=36) 相比,非静脉注射LVRS (n=36) 的90天死亡率较低 (3%vs. 7%) 和胸管持续时间较短 (5vs. 8天).
- 在非输管组中,平均ICU停留时间 (4 vs. 8天) 和住院时间 (6 vs. 10天) 显著减少.
- VV ECLS 支持持续时间相似 (3 vs. 4 天),提高了高风险患者的手术内安全性.
结论:
- 非输管的VATS-LVRS在患有高头症的肺气患者中有效且耐受良好.
- 这种技术比全身麻醉提供了显著的好处,包括降低死亡率和缩短恢复时间.
- VV ECLS是一种有价值的辅助,可以提高高风险LVRS患者的安全性和减少并发症.
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