摘要
目的探讨双肺同期大容量肺灌洗治疗尘肺近中期疗效及并发症,便于临床推广应用。方法采用双侧同期大容量肺灌洗术对39例煤工尘肺病患者进行肺灌洗治疗,测定第1瓶和最后1瓶灌洗液蛋白质含量、细胞总数及分类、白介素-6及肿瘤坏死因子;观察灌洗前后临床症状及动脉血氧分压情况;分析术后半年肺功能及运动能力变化。结果最后1瓶灌洗液细胞总数、白介素-6及肿瘤坏死因含量均明显降低,差异有显著意义(P<0.05);术后1周动脉血氧分压高于术前(P<0.05);术后6个月肺通气功能及各项运动能力指标有明显改善(P<0.05)。结论双侧同期大容量肺灌洗可有效清除中小气道内的有害粉尘、炎性细胞和炎性介质,明显改善煤工尘肺患者的临床症状、提高患者的动脉血氧分压,改善患者的肺功能和运动能力。近中期疗效较好,值得临床推广应用。MWLL术也可能导致一过性肺创伤,故术中和术后应加强临床的监护和治疗。
Objective To discuss mid-term effects of massive whole lung lavage（ MWLL） on lung functions of patients with coal workers＇ pneumoconiosis and its complications so as to provide reference for clinical popularization. Methods Thirty nine patients with coal workers＇ pneumoconiosis received bilateral synchronous MWLL;the protein content,total number of cells and classification,interleukin 6,tumor necrosis factor of the first bottle and the last bottle of lavage fluids were determined; clinical symptoms and arterial blood oxygen partial pressure before and after lavage were observed; lung functions and exercise capacity changes six months after the operation were analyzed. Results The lavage cell count,interleukin 6 and tumor necrosis factor contents in the last bottle were significantly lower than in the first bottle（ P〈0. 05）; arterial blood oxygen partial pressure 1week after the operation was higher than the preoperative level（ P〈0. 05）; lung ventilation function and exercise capacity indicators improved significantly six months after the operation（ P〈0. 05）. Conclusion Bilateral synchronous MWLL can effectively remove harmful dust,inflammatory cells and media in small airway ducts,significantly alleviate clinical symptoms of patients with coal worker ＇ s pneumoconiosis,increase patients ＇ arterial blood oxygen partial pressure and improve patients＇ functions and exercise capacity. With good mid- term therapeutic effects, MWLL deserves clinical popularization.Nevertheless,MLL may lead to transient pulmonary trauma,so intraoperative and postoperative clinical monitoring and treatment should be enhanced
出处
《预防医学情报杂志》
CAS
2016年第6期551-555,共5页
Journal of Preventive Medicine Information
关键词
煤工尘肺
白介素-6
肿瘤坏死因子
肺功能
运动能力
coal workers pneumoconiosis
interleukin-6
tumor necrosis factor
lung function
exercise ca pacity
