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支气管镜肺体积减小:突出显示患者选择过程

Max J Martin¹, Megan M Dulohery Scrodin¹, Eric S Edell¹

¹Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.

Mayo Clinic proceedings

|September 3, 2023

概括

一种多学科的方法改善了患者选择的支气管镜肺体积减小 (BLVR) 带内支气管,提高了晚期肺患者的结果. 仔细查将不合适的候选人排除在外,优化治疗的成功.

科学领域:

肺部病理学肺部病理学
干预性肺病学干预性肺病学
胸部外科手术胸部外科手术

背景情况:

晚期肺气的严重呼吸障碍往往需要除了医疗治疗之外的干预措施.
越来越多地使用使用内支气管的支气管镜肺体积减小术 (BLVR).
有效的BLVR高度依赖于细致的患者选择.

研究的目的:

详细介绍一个机构对BLVR患者的选择过程.
分析这种选择过程对程序结果的影响.
强调在BLVR候选人评估中多学科方法的重要性.

主要方法:

从2019年3月到2021年10月,对2402名转诊患者进行了审查.
对161名被考虑接受BLVR的患者进行了多学科审查.
排除标准和程序结果的分析.

主要成果:

32.9%的审查患者被选为门;21.7%接受了手术.
不兼容的CT分析,恶性瘤和需要康复是排除的主要原因.
58.6%的人实现了目标叶片崩,与螺旋计改善相关.
并发症包括肺胸部 (34.3%) 和需要进行二次手术的患者 (19).

结论:

多学科的方法使BLVR的候选人选择个性化.
这一过程有效地排除了不太可能受益或面临更高风险的患者.
优化的选择提高了BLVR程序的成功率和安全性.

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