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目的评估CT扫描联合计算机软件系统对支气管内单向活瓣(EVB)肺减容术患者筛查的价值。方法收集2013年11月至2014年11月广州医科大学附属第一医院诊断为重度慢性阻塞性肺疾病(慢阻肺)且行胸部高分辨率CT(HRCT)检查的患者550例。随机抽取121例,将HRCT导入VIDA软件系统自动分析各肺叶肺气肿含量及叶间裂完整性,计算、分析符合EVB置入肺减容术CT要求的概率及靶区肺叶分布情况。结果均匀性肺气肿101例(83.5%),非均匀性肺气肿20例(16.5%);叶间裂完整97例(80.2%),叶间裂不完整24例(19.8%);同时符合非均匀性肺气肿、叶间裂完整15例(12.4%)。靶区肺叶分布为:右上叶10例,左上叶1例,双上叶2例,双下叶1例,左下肺1例;上叶占83.3%(15/18),下叶占16.7%(3/18)。结论仅有少数重度慢阻肺患者符合EBV肺减容术CT筛查标准,CT扫描联合计算机软件系统是对重度慢阻肺患者行EVB肺减容术筛查的重要评估手段。
Objective To assess the value of CT scan combined with computer software in the screening of lung volume reduction in one-way intrabronchial valve (EVB). Methods A total of 550 patients diagnosed as having chronic obstructive pulmonary disease (COPD) underwent chest high resolution computed tomography (HRCT) at the First Affiliated Hospital of Guangzhou Medical University from November 2013 to November 2014 were collected. 121 cases were randomly selected. The HRCT was imported into the VIDA software system to automatically analyze the pulmonary lobes emphysema and the integrity of the interlobar rupture. The probability of complying with the CT requirements of the lung volume reduction surgery and the distribution of the lung lobes in the target area were calculated and analyzed. RESULTS: There were 101 cases of emphysema (83.5%), 20 cases of non-uniform emphysema (16.5%), 97 cases (80.2%) with intact rupture and 24 cases (19.8%) with incomplete rupture of the spleen. In line with non-uniform emphysema, complete rupture of the spleen in 15 cases (12.4%). The distribution of target lung lobes were: 10 cases of right upper lobe, 1 case of upper left lobe, 2 cases of double lobe, 1 case of double lower lobe and 1 case of left lower lobe. The upper lobe accounted for 83.3% (15/18) and the lower lobe accounted for 16.7% 3/18). Conclusions Only a few severe COPD patients meet the criteria of EBV lung volume reduction CT screening. CT scan combined with computer software system is an important evaluation method for EVB lung volume reduction screening in patients with severe COPD.