- 期刊
Clinical Outcomes of Thoracoscopic Bullectomy for Giant Bullous Lung Diseaset
以胸腔鏡肺疱切除術治療巨大肺大疱疾病的臨床療效
摘要
前言：巨大肺大疱（giant bullous lung disease）是一種罕見的疾病。利用胸腔鏡行肺疱切除術為臨床上的治療方法之一。本研究的目的在於探討胸腔鏡肺疱切除術應用在巨大肺大疱疾病的臨床效益。材料與方法：研究透過2010 年一月至2014 年十二月間，收集一共28 位巨大肺大疱疾病的病人，其中24 位為男性，4 位為女性。所有患者均接受胸腔鏡肺疱切除術。患者平均年齡為50.4 歲，年齡分布從18 歲到85 歲。患者中有5 位過去曾罹患肺結核疾病。結果：11 位病患有術後的併發症產生，包括7 位併發肺炎，3 位術後持續漏氣，3 位發生呼吸衰竭的情形，另有1 位術後出血需要手術介入。患者平均住院天數為7.1 天。18 位患者在接受過手術後主訴氣喘症狀有改善。6 位患者其術後的肺功能有顯著的進步。結論：胸腔鏡肺大疱切除術對於巨大肺大疱患者的治療除了能有效改善患者症狀以外，同時也是一項安全可行的手術。
並列摘要
Introduction: Giant bullous lung disease is a rare occurrence. Various surgical procedures have been used, although little is known about the clinical outcomes of thoracoscopic bullectomy. Methods: We reviewed the medical records of 28 patients (24 males and 4 females) with giant bullous lung disease who underwent thoracoscopic bullectomy from January 2010 to December 2014. Mean age was 50.4 years (ranging from 18 to 85 years). Twenty patients were heavy smokers, 7 had chronic obstructive pulmonary disease, and 5 had been treated for pulmonary tuberculosis. Dyspnea was the most common symptom. Results: Eleven patients (39.9%) had postoperative complications, including pneumonia in 7 (25%), persistent air leakage in 3 (10.7%), respiratory failure in 3 (10.7%), and bleeding in 1 patient (3.6%). Mean postoperative hospital stay was 7.1 days. Dyspnea improved in 18 patients (64.3%), and 6 patients with preoperative pulmonary function tests showed obvious improvement postoperatively. Mean follow-up was 18.4 months (ranging from 1 day to 59 months). Conclusion: Most patients had symptomatic relief after treatment. Previous pulmonary tuberculosis would increase treatment morbidity. Thoracoscopic bullectomy is a safe and advisable surgical procedure for giant bullous lung disease.