摘要
目的探讨改良大容量全肺灌洗术(WLL)治疗尘肺的临床效果及安全。方法按随机数字表进行抽样,32例二期或三期尘肺病患者行分侧WLL,采用患者自身左右肺配对对照研究。治疗侧肺(治疗组)采用改良WLL,即共灌洗9次,在灌洗第2、4、6、8次末经气管导管注入复方异丙托溴铵后再行加压通气,灌洗第9次末行加压通气,每次加压通气时鼓肺6次。对侧肺(对照组)采用常规WLL,即共灌洗12次,在灌洗第3、6、9、12次末行加压通气,每次加压通气时鼓肺4次。比较两组的灌洗时间、灌洗液的残留量、灌洗出的粉尘含量、术中及术后并发症、费用。结果治疗组灌洗时间、灌洗液的残余量及费用均少于对照组(P<0.01);治疗组的粉尘含量明显多于对照组(P<0.01);两组术中及术后并发症比较差异无统计学意义。结论与WLL比较,改良WLL治疗尘肺病能获得更好的临床效果。
Objective To investigate the clinic effect and safety of modified whole lung lavage(mWLL)in the treatment of pneumoconiosis.Methods By random sample,36patients with stage II or III pneumoconiosis,had differential whole lung lavage(WLL).Using the patient's own left and right pulmonary matched control study.The treatment side lung(treatment group)using mWLL,which lavaged a total of9times,the positive pressure ventilation was performed at the end of2,4,6,8,9lavages after compound ammonium bromide filled in tracheal catheter at the end of2,4,6,8lavages,and lung dilated6times during each pressure ventilation.The contralateral lung(control group)lavaged a total of12times,the positivepressure ventilation was implemented at the end of3,6,9,12lavages,and lung dilated4times during each pressure ventilation.Compared the lavage time,the amount of residual liquid,the total dust amount,operative and postoperative complications,and cost between the two groups.Results The lavage time,the residual liquid volume and the cost of the treatment group were significantly less than that of the control group(P<0.01).The total dust amount in the treatment group was significantly higher than that in the control group(P<0.01).There were no significant differences in operative and postoperative complications between the two groups.Conclusion Compared with WLL,the pneumoconiosis can get better clinical results by mWLL.
作者
陆小娜
方育霞
杨蓉美
章蕾
黄建华
吴海燕
罗旭阳
王玉
苏盈笑
李光明
Lu Xiao-na;Fang Yu-xia;Yang Rong-mei;Zhang Lei;Huang Jian-hua;Wu Hai-yan;Luo Xu-yang;Wang Yu;Su Ying-xiao;Li Guang-ming(Department of respiration, Jiangxi Chest Hospital, Nanchang, Jiangxi, 330006, China)
出处
《当代医学》
2017年第30期4-6,共3页
Contemporary Medicine
基金
江西省卫生厅科技计划(20143180)
关键词
改良全肺灌洗
尘肺
治疗
Modified whole lung lavage
Pneumoconiosis
Treatment
