论文部分内容阅读
目的 评价肺通气 灌注 (V P)显像对慢性阻塞性肺病 (COPD)肺容积减少术 (LVRS)病例的选择及手术部位和范围确定的价值。方法 12 8例COPD患者 (均为男性 ,年龄 45～ 76岁 )进行V P显像 ,其中 2 9例 (年龄 45～ 74岁 )进行LVRS治疗 ,术后 3～ 6个月复查。通气显像采用99Tcm DTPA气溶胶吸入法 ,灌注显像用99Tcm 人血清聚合白蛋白 (MAA)静注法。根据显像类型分成①局灶型 :即肺内放射性分布不均匀 ,局部肺组织有明显分布稀疏缺损区 ,而其他部位相对较好 ;②弥漫型 :即两肺内放射性弥漫性稀疏缺损。结果 LVRS治疗的 2 9例患者V P显像均呈局灶型 ,外科根据显像所提示的局部病变部位及范围进行手术 ,术后 3～ 6个月患者肺功能均得到明显改善 ,手术前后 1s用力呼气容积占用力肺活量比值 (FEV1 0 % )分别为 (35 88± 6 2 7) %与 (6 6 15± 3 99) % ,t=3 986 ,P <0 0 0 1。结论 V P显像对COPD进行LVRS治疗的手术病例选择及手术部位和范围的确定具有重要的参考价值
Objective To evaluate the value of pulmonary ventilation (V P) imaging in the selection of the patients with chronic obstructive pulmonary disease (COPD) with pulmonary volume reduction (LVRS) and the determination of the operative site and extent. Methods Twenty-eight COPD patients (all men, aged 45-76 years) underwent V P imaging. Among them, 29 patients (aged 45-74 years) underwent LVRS and were reviewed 3-6 months after operation. Ventilation using 99Tcm DTPA aerosol inhalation perfusion imaging with 99Tcm human serum albumin (MAA) intravenous injection method. According to the type of imaging is divided into focal type: the uneven distribution of radioactive lungs, local lung tissue with sparsely distributed defect area, while the other parts are relatively good; diffuse type: that radioactive diffuse sparse defect in both lungs. Results Among the 29 patients with LVRS, the VP imaging was focal. According to the location and extent of the local lesion indicated by the imaging, the lung function of patients with LVRS was significantly improved 3 to 6 months after surgery. The forced vital capacity expresion (FEV1 0%) was (35 88 ± 6 27)% and (6 6 15 ± 3 99)%, t = 3 986, P 0 01, respectively. Conclusion V P imaging of COPD in the treatment of LVRS cases of surgical options and the determination of surgical site and range of important reference value