The article showed the results of ultrasonic assessment of topographic and functional diaphragm indices in patients with severe diffuse emphysema. They passed the selection for lung volume reduction surgery. The comparison of diaphragm indices was presented in patients with diffuse emphysema and control group of healthy volunteers. Dynamics of diaphragm condition was studied after surgical treatment. There wasn’t noted any statistical difference of diaphragm topographic indices as compared with the control group. There wasn’t shown a correlation between respiratory function indices and functional diaphragm indices, but it was noted a positive tendency in characteristics during quiet breathing.
The OBJECTIVE is to estimate the immediate and long-term results of palliative surgical correction of the respiratory failure (RF) depending on the variants of emphysematous lesion of the lungs. MATERIAL AND METHODS. 175 patients with the severe pulmonary emphysema (PE) were operated, 111 resections of large and giant bullas (RB) (55.5 %), 85 lung volume reduction surgery (LVRS) (42.5 %) were performed, the proportion of repeated interventions on the contralateral lung were 12 %. RESULTS. Complications in the early postoperative period were in 107 patients (53.5 %), postoperative lethality was 12.0 % (n=24). Complications in the group of patients with the absence of practically preserved lobe were in 84 patients (69.4 %) while the complications in the group with practically preserved lobe were revealed only in 23 patients (29.1 %) (p=0.001). After RB in the groups where bullas adjoined to almost unchanged pulmonary tissue, the lethality during the five-year observation period was much less, than in the groups with clinically significant pulmonary emphysema in the remaining after operation part of a lung, 4.1 % and 40.0 % respectively (p=0.001). CONCLUSION. After the palliative surgical correction of RF through RB or LVRS, the most favorable survival criterion is the presence of parenchyma in the operated lung, which is practically not affected with emphysema.
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