不做大型手术 也能治愈肺病?

时间:2021-01-19 00:15 作者:亚博网页版
本文摘要:hospitalsaretestingnewprocedurestohelppatientswithadevastatinglungdiseasebreatheeasierwithoutmajorsurgery .帮助患有可怕肺病的患者即使接受了大手术,more than 15 million Peoplehave beendiagnosed with Chronicobstructive Pulmonary Disease,or COPD, accordingtothec

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hospitalsaretestingnewprocedurestohelppatientswithadevastatinglungdiseasebreatheeasierwithoutmajorsurgery .帮助患有可怕肺病的患者即使接受了大手术,more than 15 million Peoplehave beendiagnosed with Chronicobstructive Pulmonary Disease,or COPD, accordingtothecentersfordiseasecontrolandprevention.millionsmoremaybeunawaretheyhaveit.thediseaseisthethirdleadingcauses h in t afterheartdiseaseandcancer.copdcostsnearly $ 30 billionindirecthealthcareexpenditures .美国疾病管理和防治中心(centersfordieseasecenters 在美国,这种病是继心脏病和癌症之后的第三大死因。在必要的医疗费用中,化疗慢性阻塞性肺疾病的相关费用约为300亿美元。

COPD is mainly caused by smoking, buttheconditionalsohasbeenlinkedwithsecondhandsmoke是airpollutionandworkplacedustandchemicals.genesmayplayaroleinwhysomesmoke 基因也可能有些不起作用。所以有些吸烟者不会成为COPD患者,也不会生病。

somepatientswithseverecasesofcopdmaybereferredforsurgery是duringwhichthediseasedpartofthelungisremoved.buttheriskyandcostlype partlybecauserecoveryislongandmanypatientsexperiencecomplicationsaftersurgery .在病情严重的COPD患者中,为手术送去,通过手术切除肺部的恶性肿瘤部位但是有这样的风险,没有财力的化疗手段经常被使用。部分原因是手术后恢复期长,很多患者还没有患上术后并发症。morethantwodozenu.s.medicalcentersarecurrentlytestingatechniquethatplacesmetalcoilsintothelungusingspecialscopesinserting the lace是, thecoilscompressthediseasedtissueandallowthehealthierpartsofthelungtobreathemorefreely.otherhospitalsareinvestigatingasmalls r ectsairfromlesshealthytomorehealthypartsofthelung .现在美国有20多个医疗中心正在测试新技术。

将类似的内窥镜通过口腔和鼻腔进入人的体内,用它在所有地方以后,金属线圈不会破坏恶性肿瘤的组织,使肺的健康部位更有权利地排便。其他医院也在研究将空气从肺状态良好的部位引导到更健康的部位的小伞状阀门。

If successful,wewillbeabletohelpasignificantnumberofpatientshaveanimprovedqualityoflife,andpotentiallyimprovesurvivalinanonine says Atul C. Mehta,aninterventionalpulmonologistatclevelandclinic。onethecentersparticipatinginthecoilstrial .克利夫兰医院(Cleveland Clnic )的介入治疗医生阿尔图尔C梅塔(Atul C. Mehta )说:“如果克利夫兰医院是参加线吗? 是化疗试验的医学中心之一。In Europe,wherethecoilshavebeenapprovedforusesince 2008, studieshaveshownthetreatmentissafeforpatientsandresultsinsignificantimprovementsinpulmonaryfunction, exercisecapacityandqualityoflife.currentu.s.researchisbeingfundedbypneumrxinc .the Mountainview, Calif . makerofthecoils.whilesmokerscanpreventcopdbyquittingbeforeitdevelops, oncethelungsaredamageditisntreversible.mostpatientsaremanagedwiththeuseofinhaledmedicationscalledbronchodilators,oxygeents偏航现在,美国的研究由加利福尼亚州山景城(Mountainview,Calif.)的RneumRx Inc .公司支持,该公司是使用的线圈制造商。

吸烟者可以在慢性阻塞性肺疾病构成前戒烟开展防治,但肺破损后病情不能逆转。很多患者被名为支气管扩张剂的吸入性药物用氧气和肺康复疗法保持着。Mary Morgan,a nurse who lives in Parma,HIO,Wasdiagnosedsevenyearsagowithemphysema,a form of COPD. Still, shecontinuedtosmokeforafewmoreyearsbecausethediseasewasntbotheringme,she says. Two years ago, the 55-year-oldcamedownwithpneumoniaandhadtocall 911 becauseshecouldntbreathe.shequitsmokingbutneededtobeonoxygenallto egaspedfe ospeakmorethanafewwordsatatime.itgetstothepointwhereyouarelivinginsuchmiserythatyouju ST dont want to go on,Ms. Morgan says .玛丽摩根7年前,她发病于肺气肿,肺气肿是慢性阻塞性肺疾病的表现形式。

尽管如此,她后来抽了好几年烟。因为她说“没留下什么后遗症”。

两年后,55岁的摩根得了肺炎,不得不打911急救电话。因为不能排便了。她抽烟,但不得不抽氧。

她还经常喘气,说话时一次说不出几个词。摩根说:“我已经病到这种地步,这么痛苦,我想再活下去。” aftercompletingapulmonaryrehabilitationprogram, ms.morganwasacceptedintothecoilstrialattheclevelandcliniclastdecember.dr.mehtaandanotherpulmonologistplaced 12 of the inherrighi dfromthehospitalafterjustonenightandsaysshefeltimprovementsalmostimmediately.testsa tershowedherbreathinghadimprovedby 30 %.shee enandisscheduledtohaveadditionalcoilsinsertedinherleffed la ter this month .摩根结束肺康复化疗后,去年12月在克利夫兰医院拒绝进行线圈试验化疗梅塔医生和另一位肺科专家在她的右肺下部移植了12个小线圈。她说术后只在医院待了一夜后住院,自己完全很快就感觉好了。

一个月后的测试显示,她的排便状况提高了30%。她还在补充氧气,计划本月晚些时候将另一个线圈移植到左肺。

COPD includes two main conditions,emphysema and chronic bronchitis,andmostpatientshaveelementsofboth.emphysema,asit addit destroys t or alveoli, thatexchangeairbetweenthelungsandsurroundingtissueandbloodstream.diseasedportionsofthelungoverinflate是becomeinelasticandtrate theexpandedsacspushagainstthelungshealthierareas.patientsmayfeelasiftheyaresuffocating.medicationsmayceasetowork .慢性 随着肺气肿的病情减轻,它不会破坏气体吗? 也称为肺泡——,管理肺和周围组织和血流之间的空气交换。肺的恶性肿瘤部位不会过度收缩,看起来没有弹性,空气滞留。同时,扩张的气囊不会断裂肺部比较健康的部位。患者可能窒息死亡,药物化疗可能过热。

moreseverecasesofcopdaffectanestimatedthreetofourmillionpeopleintheu.s.dr.mehtaestimatesasmanyasonemillionmaybecannet somefoo oughsurgeryorthenewless-invasivecoilprocedure.thesurgeryrequiresalargeincision是or several small ones, inthechesttoexcisediseasedtissue.theaimistoallowthepatienttobreatheeasierwitheremaininghealthierpith梅塔医生说100万人通过手术做了什么这种手术必须在胸部开一个大切口或一些小切口对恶性肿瘤的组织进行手术。其目的是使患者在余下的肺比较健康的部位容易排便。In a large study a decade ago,calledthenationalemphysematreatmenttrial,thesurgerydidntshowanoverallsurvivaladvantageovermedical management.itdidshowanadvantageinpatientswhosediseasewasworseinupperlobesofthelungsandwhoseexercisecapacitywaslow。

theprocedureislittleused.complicationratesarehigh.relativelyfewcentersinthecountryoffertheprocedure.10年前展开的项目的名称为l emphyy 这个研究反而指出,在一些患者中,手术疗法非常占优势的——患者的上肺叶恶性肿瘤更严重,他们的运动能力也差。尽管如此,这种化疗的手段还是不怎么被使用。那个并发症的患病率也很低。

在美国,接受这种治疗方法的医疗中心也很少。In the right patients,weveproventhatlungreductionsurgeryworks, butdoctorsarentreferringpatientsfortheprocedureandpatientsarenterestedindoingmajorsurgery,says Frank Sciurba, directorofthepulmonaryfunctionandexercisephysiologylabattheuniversityofpittsburghmedicalcenterandprincipalinvestigatorforitspa ial.oneaimofthetrial,he says, istodeterminewhichpatientshavetherightlungstructureandphysiologytobenefitfromthecoilsprocedure .匹兹堡大学医学中心(universityofpie dical Center的肺功能和运动生理学研究所(pulmonaryfunctionandexercisephysiologylab )主任,该校部分线圈移植试验的主要研究者弗兰克休巴(Frank Sciurba )说。他还说,实验的目的之一是确认什么样的患者具有适合环境线圈疗法的肺部结构和生理功能,从而从这种疗法中受益。thecoilstrialisntstudyingcosts.inthelongrunthehopeisthiscouldbemorecost-effective,says Dr. Sciurba是by reducing hospital ization complicationsandreadmissions.apneumrxspokeswomansaysthecoilsprocedureineuropecosts $。

000.wearentyetfarenoughalongintheu.s.markettohaveavalidcomparison,she says .线圈疗法的相关试验没有探究成本问题。休巴博士说:“将来的期待会比(减少住院成本、增加并发症、重新开始住院)更高。” PneumRx公司的女发言人说,开展线圈疗法在欧洲需要1.5万美元。

她说:“我们还不了解美国市场,所以无法进行有效的比较。” expertshavehadmixedresultswithothernonsurgicaltechniques, suchaschemicalsealantsandsteamtodestroythediseasedpartofthelung.inanothercurrentclinicaltrial, researchersareguidingasmuiding umbrella-shapedvalveintotheairwaysthatredirectsairfromlesshealthytomorehealthypartsofthelungwhii liertrialofthevalvesendedwithoutmeetingtherequirementsforfooddrugadministrationapproval,but Redmond, Wash .device maker Spiration Inc . isfundinganewtrialtodetermineiftheprocedurecanhelpreduceover-inflationofthelungandimproverallungfunctionandqualityoflity等在现在的另一个临床试验中,研究者的机车小伞型阀门进入呼吸道,从肺好的部位向肺更健康的部位引导空气,同时排出剩下的空气。早期的阀门疗法试验因不服从美国食品药品管理局(Food Drug Administration )的证书而结束,华盛顿州雷德蒙德市(Redmond,Wash.)的器具制造商Spiration Inc .公司出资进行了新的试验D. Kyle Hogarth,directorofbronchoscopyandassistantprofessorofmedicineattheuniversityofchicagowhoisleadinganarmofthevalvestudyte saysapossiblerisktotheuseofanydeviceisinfectionfromforeignbodiesinsertedintothelung.whilecoilsarentdesignedtoberemoved, valvescouldberemovedifnecessary,he says.becauseemphysemacanaffectindividualpatientslungsdifferently,in the future, patientsmayendupqualifyingforbothcoilsandvalves, totreatdifferenttypesofabnormalitiesandbreathingproblems是Dr. Hogarth says .芝加哥大学(University of Chicago )的支气管镜检查主任、医学助理教授d凯尔他说,不管用于什么器具设备,移植到肺部的外来物都没有引起病毒感染的风险。他还说,线圈本身没有设计成可以去除,但阀门只要合适就可以切除。

肺气肿对每个患者肺的影响因人而异,因此患者将来可能会展开弹簧圈植入,或者拒绝阀门疗法。霍加斯博士说:“因为化疗,疾病和排便的问题不同。


本文关键词:不做,大型,手术,也能,亚博网页版,治愈,肺病

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