大容量全肺灌洗术治疗合并严重低氧血症肺泡蛋白沉积症1例并文献复习

Large-capacity whole-lung lavage in 1 patient with pulmonary alveolar proteinosis and severe hypoxemia and literature review

对中南大学湘雅医院呼吸内科首例行大容量全肺灌洗术成功治疗合并严重低氧血症的肺泡蛋白沉积症患者的临床资料进行分析,并复习相关文献。男性患者,35岁,咳嗽、气促2年余入院。入院检查发现患者严重低氧血症,双肺弥漫性间质病变,经肺活检诊断肺泡蛋白沉积症,在静脉全麻下经双腔气管插管,大容量全肺灌洗术。并联合使用粒-巨噬细胞集落刺激因子(granulocyte-macrophage colonystim ulating factor,GM-CSF)皮下注射。术后患者自觉症状明显改善,胸部CT及动脉血气均有明显改善。

To improve the diagnosis and treatment of pulmonary alveolar proteinosis, clinical data for the first successfully treated case of pulmonary alveolar proteinosis with severe hypoxemia by large-capacity wholelung lavage in our hospital were analyzed, and relevant literatures were reviewed. A 35-year-old Han male initially presented two years ago with increasing cough and dyspnea was admitted to our hospital Admission examination revealed severe hypoxemia, interstitial lung disease, and heavy protein deposition in the alveoli by lung biopsy The patient received large-capacity whole-lung lavage in the operation room under general anesthesia and treatment of granulocyte-macrophage colony stimulating factor （GM-CSF）. The patient＇s symptoms of dyspnea were alleviated markedly; and radiological findings improved and A-aDO2 decreased.