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KMID : 1141720170050020002
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폐쇄성폐질환
2017 Volume.5 No. 2 p.2 ~ p.2
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GOLD 2017 Update - Lung Volume Reduction
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Lee Sei-Won
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Abstract
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The treatment of emphysema is based on bronchodilators, but it has limitation in emphysema dominant phenotype. To overcome this limitation, lung volume reduction (LVR) therapy is developed to reduce hyperinflation. Until 2016 GOLD document, bronchoscopic lung volume reduction (BLVR) is recommended only under clinical trials. However, new evidences enable this therapy be utilized in clinical practice. Those evidences include clinical efficacy of bronchial valve and lung coil in targeted patients. Bronchial valve showed marked improvement of lung function in patients without collateral ventilation. Lung coil also improved exercise capacity and symptom. Based on these data, GOLD 2017 recommended these two methods (bronchial valve and coil) for the clinical application in well selected patients. For patients with upper dominant emphysema and complete fissure, every method including surgery can be applied. For the case with incomplete fissure, lung coil and surgery can be considered. BLVR was added in new treatment for emphysema in GOLD 2017, but the methods and target patients should be selected carefully.
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KEYWORD
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Emphysema, Chronic obstructive pulmonary disease, Lung volume reduction, Bronchoscopy
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