低浓度克矽平大容量全肺灌洗治疗煤工尘肺后六年的疗效观察

Curative effect of large volume whole lung lavage with low concentration of poly-2-vinyl pyridine n oxide on the coal workers'pneumoconiosis after 6 years

目的 观察低浓度克矽平大容量全肺灌洗术治疗煤工尘肺的疗效。方法 42名男性煤工尘肺患者用分层配对方法确定治疗组和对照组。治疗组 2 1名患者接受大容量肺灌洗术治疗。两组随访时进行问诊调查、肺功能和胸部X线摄片检查。结果 肺灌洗治疗能洗出一定量的粉尘 ,其中快型尘肺平均每例的粉尘洗出量为 981.2mg,明显多于慢型尘肺 (386 .2mg) ,差异有显著性 (P <0 .0 5 ) ;治疗组疗前、疗后 2年、疗后 6年的FEV1.0 值分别为 3.35、3.2 9和 2 .75L ,对照组为 2 .95、2 .73和 2 .41L ,均随年龄增加有下降趋势 ,但两组的差异无显著性 (P >0 .0 5 )。治疗组治疗后 6年胸片的稳定率和进展 (进展及明显进展 )率分别为 42 .1%和 5 7.9% ,对照组分别为 5 7.9%和 42 .1% ,两组的差异无显著性 (P >0 .0 5 )。结论 大容量全肺灌洗术能洗出肺内一定量的粉尘 。

Objective To observe the curative effect of large volume whole lung lavage with low concentration of poly 2 vinyl pyridine n oxide(P204) on the coal workers'pneumoconiosis. Methods 42 male patients were selected as research subjects.21 patients were selected to accept the treatment and another 21 as controls.A standard questionnaire investigation,lung function and chest X ray examination were done in both groups of the patients. Results The mean amount of dust washed out from a patient's lung was 981.2 mg in the rapid type patient group and 386.2 mg in the slow type patient group( P <0.05).Before treatment and 2 years,6 years after treatment,the value of FEV 1.0 ,were 3.35 L,3.29 L and 2.75 L respectively in the treatment group,and 2.95 L, 2.73 L and 2.41 L respectively in the control group.Lung function decreased in both groups by aging without statistical difference( P >0.05).6 years after treatment,the rate of stability and aggravation of X ray examination of chest were 42.1% and 57.9% in treatment group and 57.9% and 42.1% in control group,respectively without statistical difference ( P >0.05). Conclusion The dust could be washed out from the lung by large volume whole lung lavage but there were no evidences of improvement of lung function and prevention from aggravation of pathological change 6 years after treatment.