Abstract：
Bronchoscopic lung volume reduction treatment with Zephyr one-way valves is an effective guideline-based treatment option for patients with severe emphysema and hyperinflation. However, in some cases the treatment response is less than anticipated or there might be a loss of initial treatment effect. Reasons for the lack of response can include incorrect assessment of collateral ventilation, improper valve placement, or patient related factors. Loss of initial benefit can be due to granulation tissue formation and subsequent valve dysfunction, or there may be side effects such as excessive coughing or infectious problems. Careful follow-up after treatment with valves is important and evaluation with a CT scan and/or bronchoscopy is helpful if there is no improvement after treatment or loss of initial benefit. This paper aims to describe the most important causes and provide a strategy of how to approach and manage these patients.
摘要：
使用Zephyr单向瓣膜的支气管镜肺减容治疗是严重肺气肿和过度充气患者的有效基于指南的治疗选择。然而,在某些情况下，治疗反应低于预期，或者可能失去初始治疗效果。缺乏反应的原因可能包括不正确的侧支通气评估，阀门放置不当,或患者相关因素。初始获益的丧失可能是由于肉芽组织形成和随后的瓣膜功能障碍。或者可能有副作用，如过度咳嗽或传染性问题。瓣膜治疗后的仔细随访很重要，如果治疗后没有改善或失去初始益处，则用CT扫描和/或支气管镜检查进行评估是有帮助的。本文旨在描述最重要的原因，并提供如何接近和管理这些患者的策略。
