全肺灌洗术治疗尘肺的临床效果观察

Cinical Observation on Therapy of Pneumoconiosis with Whole Lung Lavage

目的探讨全肺灌洗术治疗尘肺病的临床效果。方法对10例不同期别的尘肺病患者,在静脉复合麻醉下进行双腔支气管插管,并将双肺成功隔离,一侧肺纯氧通气,一侧肺采用灌洗液反复灌洗,并于灌洗前及灌洗后分别测定血气、肺功能。全肺灌洗治疗后动脉血氧分压与治疗前对比其改变有统计学意义(P<0.05);相反,动脉血二氧化碳分压、肺通气功能以及肺弥散功能灌洗治疗前后均无统计学意义(P>0.05)。结果成功进行双肺同期肺灌洗10例,术中顺利,术后临床症状消失,无明显术后并发症。结论全肺灌洗术疗效好、安全,并发症发生少,是治疗尘肺病安全、有效的治疗方法之一。

Objective To explore the clinical outcomes of whole lung lavage for the therapy of pneumoconiosis. Methods Ten patients with pneumoconiosis at various stage were performed double-lumen endotracheal intubation under the condition of combined intravenous anesthesia, and the bilateral lungs were successfully isolated from each other. Ventilation with oxygen （ Fi = 1.0） was carried out to one lateral lung and repeated lavage was meanwhile conducted to the other lateral lung. In the end, both the bilateral / lungs were given lavage. Blood gas and lung function were detected before and after lavage. The change in arterial partial pressure of oxygen （ PaO2 ） after lavage was statistically significant when it was compared with that before whole lung lavage （ P 〈 0.05 ）. On the contrary, there were no obvious differences in arterial partial pressure of carbon dioxide （ PaCO= ） and lung ventilatory or diffuse fuction between before and after lavage （P 〉 0.05 ）. Results Successful bilateral lung lavage was conducted in the ten patients without obvious postoperative complications. Conclusion Whole lung lavage is effective on pneumoconiosis with safety or few complications.