9mm支气管内瓣膜(IBV)治疗晚期肺气肿的疗效和安全性

K. Kontogianni, A. Valipour, V. Gerovasili, D. Gompelmann, F. Herth, R. Eberhardt
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引用次数: 0

摘要

背景:内镜下瓣膜治疗的目的是肺体积减少(ELVR),这与改善肺气肿患者的肺功能、运动耐量和生活质量有关。选择支气管内瓣膜的大小来实现小叶闭塞可能会影响治疗结果。方法:49例完全性叶间裂患者(♂/♀:24/25,年龄:64±7岁)在3个中心植入IBV,分别于介入后30、90、180 d随访。记录肺功能测试、6分钟步行测试(6MWT)、改良医学研究委员会(mMRC)呼吸困难量表的变化。我们使用单变量面板回归模型,使用每个感兴趣的变量作为结果(因变量),时间(以月为单位)作为自变量。该系数被解释为“研究期间每个日历月的平均变化”。正系数意味着随着时间的推移(平均而言)有增加,而负系数意味着(平均而言)有减少。结果:严重并发症中,需置胸管的气胸13例(26.5%)。结论:干预后6个月,9mm IBV瓣膜的ELVR与FEV1、mMRC和6MWT的适度但持续的改善相关。需要引流的气胸发生率为26.5%。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Efficacy and safety of the 9mm intrabronchial valves (IBV) in patients with advanced emphysema
Background: Endoscopic valve therapy aims at lung volume reduction (ELVR) that is associated with improved lung function, exercise tolerance and quality of life in emphysema patients. The size of intrabronchial valves selected to achieve lobar occlusion may have an influence on treatment outcomes. Methods: 49 patients (♂/♀:24/25, age: 64±7 years) with complete interlobar fissures, underwent IBV implantation in 3 centers and were followed up at 30, 90 and 180 days postinterventional. Changes in pulmonary function tests, 6-Minute-Walk-Test (6MWT), modified Medical Research Council (mMRC) dyspnea scale were recorded. We used a univariate panel regression model using each of the variables of interest as outcomes (dependent variable) and time (in months) as the independent variable. The coefficient is interpreted as the “average change per calendar month during the study period”. A positive coefficient means that there was an increase (on average) whereas a negative coefficient means there was a decrease (on average) over time. Results: Regarding the severe complications, pneumothorax requiring chest tube insertion occurred in 13 cases (26,5 %). Conclusions: ELVR with the 9mm IBV valves was associated with a modest but sustained improvement of FEV1, mMRC and 6MWT up to 6 months post-intervention. The incidence of pneumothoraxes requiring drainage was 26.5%.
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