内科微创肺减容术的研究进展

传统的外科肺减容术治疗慢性阻塞性肺疾病（COPD）有严格的适应证，并且副作用大、并发症多。于是人们研究出多种基于同样原理但是采用内科微创技术的减容方法。目前常用的内科微创肺减容术有使用单向活瓣、生物蛋白胶等封堵支气管使靶肺萎陷、不张，或采用支气管内药物灌注肺泡加封堵使靶肺组织纤维化等。此外，还有人提出人工旁路增加呼出气量的方法。尽管目前还缺少大规模的随机对照临床试验结果，但是内科微创肺减容术已展现了其巨大的临床应用前景，也将为治疗COPD提供更多的选择。

Advance of minimally invasive techniques for lung volume reduction

Lung volume reduction surgery(LVRS) has been shown to benefit a subset of the patients with emphysema.By contributing to distal lung collapse,the less invasive forms of lung volume reduction are novel approaches to the therapy of severe emphysema.The techniques include one-way bronchial valves,spigots or glues to act as bronchial blockers,promotion of focal atelectasis and fibrosis by injection of polymers into emphysematous region of lung after surfactant washout.Additionally,a method of radiofrequency-induced passages (fenestrations) in segmental bronchi is currently being studied.Although no prospective,randomized,controlled studies have been performed,these new approaches have great potential of clinical application to provide more choices in the treatment of COPD.