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肺体积缩小手术和肺移植的比较结果:系统性审查和元分析

Danial Ahmad¹, Brandon E Ferrell^1,2, Abhiraj Saxena¹

¹Division of Cardiac Surgery, Thomas Jefferson University, Philadelphia, PA, USA.

Journal of thoracic disease

|August 10, 2023

概括

肺体积减小 (LVR) 和肺移植 (LTx) 为COPD患者提供了可比的生存率. 肺移植显示在手术后FEV1得到改善,但其他结果在LVR和LTx之间仍然相似.

科学领域:

肺部病理学肺部病理学
胸部外科手术胸部外科手术
关键护理医学关键护理医学

背景情况:

慢性阻塞性肺病 (COPD) 管理包括肺体积减小 (LVR) 和肺移植 (LTx).
在COPD患者中,LVR和LTx之间的比较数据有限.
这项研究通过汇集现有证据来弥补这一差距.

研究的目的:

在COPD患者中比较LVR和LTx的临床结果.
综合这些手术干预的前性研究的证据.
为了评估术后变量和长期存活率的差异.

主要方法:

对2000年以来发表的前性研究进行了元分析.
从65项涉及3,671名患者 (1,445名LTx,2,226名LVR) 的研究中提取了数据.
分析了基线特征,术后变量和临床结果.

主要成果:

LTx和LVR都在1秒 (FEV1) 和6分钟步行测试 (6MWT) 中改善了强迫呼气体积.
在LTx后的FEV1明显高于LVR后的FEV1 (54.9%对32.5%,P<0.01).
没有观察到6MWT改善或组合生存率在两组之间有显著差异.

结论:

肺移植与肺体积减少相比,导致FEV1的优异改善.
总体临床结果和生存率在LTx和LVR之间是可比的.
这些发现有助于为COPD患者选择适当的外科手术.

关键词:

肺移植 (LTx) 是一种肺移植手术.国家肺治疗试验 (NETT)肺内支气管肺体积的减少肺体积减小 (LVR) 的情况肺体积缩小手术 (LVRS) 是一种手术.

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