Author/Editor		Šarenac, Tomislav; Crnjac, Anton
Title		Kirurško zdravljenje bolnika z buloznim emfizemom pri KOPB
Translated title		Surgical treatment of a patient with bullous emphysema and COPD
Type		članek
Source		Med Mes
Vol. and No.		Letnik 6, št. 1-6
Publication year		2010
Volume		str. 24-30
Language		slo
Abstract		Chronic obstructive pulmonary disease (COPD) is a chronic progressive disease, where chronic bronchitis and pulmonary emphysema co-exist. Pulmonary emphysema leads to a dramatic reduction in the area for gas exchange. Disease progress increasingly destructive, resulting in formation of bullae, forming the pulmonary dead space. Many patients with advanced COPD experience shortness of breath, which limits their physical capacity and everyday activities. Surgical therapy plays a major role in the management of advanced COPD. The methods include bullectomy, lung volume reduction surgery and lung transplantation. The article shows a case of a patient presented with COPD with bullous emphysema that was surgically treated with bullectomy due to his progressive drop of pulmonary function, physical performance, repeating pneumothoraces and low quality of life. With additional postoperative suction drainage, physical therapy and pharmacotherapy we improved patient's quality of life significantly. Despite the fact that the reduction in mortality with surgical treatment still is questionable, it has been shown that in narrowly selected groups of patients that are motivated for rehabilitation, this treatment results in meaningful advances in the mitigation of COPD symptomatology and contributes to better physical ability of patients.
Summary		Kronična obstruktivna pljučna bolezen (KOPB) predstavlja kronično napredujočo bolezen, kjer sočasno obstajata kronični bronhitis in pljučni emfizem. Pljučni emfizem vodi do dramatičnega zmanjšanja površine za izmenjevanje plinov. V teku napredovanja obolenja je destrukcija vse večja, nastajajo bule, ki oblikujejo mrtvi pljučni prostor. Mnogi pacienti z napredoavlo KOPB doživljajo pomanjkanje sape, ki jim omejuje fizično zmogljivost in jim otežuje vsakdanje aktivnosti. Kirurško zdravljenje ima veliko vlogo v zdravljenju napredovale KOPB. Sem štejemo bulektomijo, redukcijsko operacijo pljuč in presaditev pljuč. Predstavljen je bolnik z buloznim emfizemom pri KOPB, ki smo ga zaradi napredovanja upada pljučne funkcije, fizične zmogljivosti, ponavljajočih se pnevmotoraksov in nižanja kvalitete življenja zdravili kirurško z bulektomijo. S pooperativno sukcijsko drenažo, farmakoterapijo in fizikalnimi vajami smo bolniku izboljšali kvaliteto življenja. Kljub temu, da je zmanjšanje smrtnosti po kirurškem zdravljenju dvomljivo, je bilo pokazano, da pri strogo izbrani skupini bolnikov, ki je motivirana za rehabilitacijo, rezultira s pomenljivimi napredki v blaženju simptomatike KOPB in doprinese k boljši fizični zmogljivosti bolnikov.
Descriptors		PNEUMOTHORAX PULMONARY EMPHYSEMA LUNG TRANSPLANTATION