The Drainage In The Treatment Of Severe Secondary Giant Emphysematous Bullae(Attach5Case Of Patients)

Backgroud:Many of the huge pulmonary bulla which secondary to the chronic obstructive pulmonary disease with diffuse pulmonary bulla and varying degrees of emphysema,and the pulmonary ventilation and ventilation function is low. on this basis, the expansion of the pulmonary bulla squeeze more normal lung tissuearound, and reduce respiratory cavity effectively, further damage to the lung function, easy cause respiratory dysfunction and cor pulmonale, even can cause respiratory failure.It is a common cause of spontaneous pneumothorax in the elderly.The recurrence rate is high, the healing rate is extremely low, cardiopulmonary function and surgical treatment for the patient often unaffordable,and clinical treatment is very difficult.So someone try to attempt the treatment of secondary to COPDwith severe emphysema huge pulmonary bullaunder local anesthesia, its effect is obvious, but it is difficult to locate bulla or drainage tube fixed hard faults, and the rate of failure is high. Monaldi achieved more suitable method for pulmonary bulla drainage.Then Macarthur, Goldstraw etc.who are in the Brompton hospital improved the method on the basis of theMonaldi, and later was named as the pulmonary bulla Brompton drainage.But its not auxiliary operation to pulmonary bulla atelectatic and the restore inflation of the lung,and drainage for a long time will increase the pleural effusion of the incidence of complications such as infection and inflammation of the lungs.Department of thoracic surgery according to clinical practice experience, has carried on the improvement, the treatment effect is good, operation is simple, has high safety, less complications and case fatality rate is low.This article summarizes theoperations about severe secondary pulmonary bulla which used Brompton drainage for treatment with the help of thoracoscope assisted thoracic surgery in our hospital, by the way of comparison, evaluate effectiveness and safety of thoracoscope assisted Brompton drainage.Objective:By summarizing the clinical experience in a variety of drainage treatment methods about the severe secondary pulmonary bulla, evaluate the safety and effectiveness of drainage in the treatment of severe secondary bullae.Methods:5patients who underwent the drainage treatment methods for the severe secondary pulmonary bulla from February2012to April2012in our hospital which affiliated to shandong university were entered this retrospective analysis, respectively toretrospectivelyanalyze the5cases of patients with preoperative degree of postoperative short of breath, VC and FEV1%%, MVV is%, PaO2, PaCO2and other indicators.Through the methods such asmedical record read, outpatient follow-up, telephone follow-up methods to access the relevant clinical data.By the contrast of the research, evaluation the change of thoracoscope assisted Brompton drainage effectiveness and safety of treating severe secondary pulmonary bulla.Results:5routine thoracoscope assisted Brompton drainage treatment postoperatively in patients with severe secondary pulmonary bulla gains a shorter of breath symptoms were significantly improved.And the blood gas analysis and lung function index improved significantly (P<0.05), we can see some progress postoperative chest CT: review of the3cases of pulmonary bulla disappear, at least2cases has75%smaller than preoperative,the last lung recover.Pulmonary ventilation function of patients has improved, ventilation function has been significantly improved, he can do basic daily life care, and the quality of life has improved significantly.Conclusion: The Brompton drainage with the video-Assisted in the treatment of the severe secondary bullae is simple, safe, effective, less complications and low case fatality rate. It is worth to actively promote in the majority of hospitals, especially in primary hospitals.