哮喘联盟

   摘要
   背景：哮喘的管理是影响慢性哮喘患者身体健康的一个重要问题。本研究旨在阐述单侧喉上神经内支(ib-SLN)切除术治疗慢性支气管哮喘疗效确切、持久。
   患者和方法：一项回顾性研究，于2005-2013年间共纳入了41例（男性26例、女性15例）采用外科手术治疗的慢性支气管哮喘患者。所有患者在光镜下旋后位行单侧喉上神经内支切除术。35例（男性24例、女性11例）未行手术治疗的患者作为对照组。
   结果：所有手术患者的药物治疗均得以逐渐减少。与对照组相比，26%的手术患者用力呼气量(FEV)、呼气峰流速(PEF)均显著增加(p <0.05)，53.6%的患者中度增加 (FEV, p <0.05；PEF, p <0.05)。余下20%的患者FEV和PEF保持不变。总的来说，80%行单侧喉上神经内支切除术的患者，哮喘发作间隔延长、持续时间缩短，均达到了满意的效果，因此，药物治疗才得以减少。
   结论：单侧喉上神经内支切除术是一种微创治疗慢性支气管哮喘的方法，有助于预防患者窒息，甚至可以治愈窒息，且不影响咳嗽反射、呼吸调控及发声，有效避免哮喘进一步恶化。在药物治疗缺乏的地区，该方法对重度支气管哮喘和/或控制不佳的患者无疑是有益的。
 

（杨冬 审校）
BMC Surg. 2015 Oct 8;15(1):109. doi: 10.1186/s12893-015-0093-2.
 

Surgical treatment of bronchial asthma by resection of the laryngeal nerve.
 

Kurbon U1, Dodariyon H1, Davlatov A1, Janobilova S1, Therwath A2, Mirshahi M3,4.
 

Abstract
BACKGROUND:Management of asthma in chronically affected patients is a serious health problem. Our aim was to show that surgical treatment of chronic bronchial asthma by unilateral resection of the internal branch of the superior laryngeal nerve (ib-SLN) is an adequateand lasting remedial response.
PATIENTS AND METHODS:In a retrospective study, 41 (26 male and 15 female) patients with bronchial chronic asthma were treated surgically during the period between 2005 and 2013. It consisted of a unilateral resection of the ib-SLN under optical zoom, on patients placed in supinator position. 35 patients (24 male and 11 female) who were un-operated were included as a control.
RESULTS:In all patients, medication was reduced progressively. When the results were compared with the control group, it was seen that in 26 % of the patients, both forced expiratory volume (FEV) and peak expiratory flow (PEF) increased significantly (p <05) and only modestly in 53.6 % of patients (FEV, p <05 and PEF, p <05). In the remaining 20 % of patients, these parameters remained however unchanged. Overall, in 80 % of patients unilateral resection of the ib-SLN gave satisfactory results because it shortened the intervals and duration of asthmatic attacks, rendering thereby a reduction in medication.
CONCLUSION:This minimal-invasive method helped prevent/cure asphyxias in chronic bronchial asthma without affecting cough reflex,respiratory control and phonation and it helped patients avoid severe crisis. This approach is of interest for patients with severe and/or uncontrolled bronchial asthma in settings with limited access to drug treatment.
 

BMC Surg. 2015 Oct 8;15(1):109. doi: 10.1186/s12893-015-0093-2.