大容量全肺灌洗术对尘肺患者肺功能、血气指标及炎症因子的影响

Effect of Massive Whole Lung Lavage on Lung Function, Blood Gas Index and Inflammatory Factors in Patients with Pneumoconiosis

目的:探讨大容量全肺灌洗术(WLL)对尘肺患者肺功能、血气指标及炎症因子的影响。方法:选取2016年10月到2019年10月在我院接受治疗的尘肺患者48例作为本次研究对象,根据随机数字表法将患者分为WLL组和常规组各24例,给予常规组患者汉防己甲素、乙酰半胱氨酸泡腾片等常规药物治疗,在常规组的基础上给予WLL组患者联用双侧同期WLL治疗。分别于治疗前3天和治疗后2周检测并对比两组患者白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平、血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、肺泡动脉氧分压差(PA-aO2)、用力肺活量(FVC)、一秒用力呼气容积与用力肺活量的比值(FEV1/FVC%)及最大通气量与预计值的比值(MVV%)。结果:两组治疗前肺功能指标、血气指标、炎症因子水平比较差异均无统计学意义(P>0.05),两组治疗后PA-aO2较治疗前水平明显降低,FVC、FEV1/FVC%、MVV%、PaO2、PaCO2均较治疗前显著上升,IL-6、TNF-α水平与治疗前比较均明显降低(P<0.05);治疗后两组PA-aO2比较差异无统计学意义(P>0.05),治疗后WLL组的FVC、FEV1/FVC%、MVV%、PaO2、PaCO2均高于常规组,IL-6、TNF-α水平均低于常规组,差异均有统计学意义(P<0.05)。结论:WLL可明显改善尘肺患者肺功能和血气指标,降低患者血清内IL-6、TNF-α的水平,减轻炎症反应,临床疗效确切,值得临床推广应用。

Objective:To investigate the effect of massive whole lung lavage(WLL)on pulmonary function,blood gas index and inflammatory factors in patients with pneumoconiosis.Methods:48 patients with pneumoconiosis who were treated in our hospital from October 2016 to October 2019 were selected as the subjects of this study.According to the random number table method,the patients were divided into WLL group and conventional group,24 cases in each group.The patients in the conventional group were given routine drugs such as tetrandrine,acetylcysteine effervescent tablets.The patients in the WLL group were given bilateral simultaneous WLL treatment on the basis of the conventional group.The levels of IL-6,TNF-α,PaO2,PaCO2,PA-aO2,FVC,FEV1/FVC%and MVV%were measured and compared between the two groups before and after treatment.Results:There was no significant difference in lung function index,blood gas index and inflammatory factor level between the two groups before treatment(P>0.05).After treatment,PA-aO2,level in the two groups was significantly lower than that before treatment,FVC,FEV1/FVC%,MVV%,PaO2,PaCO2were significantly higher than that before treatment,IL-6,TNF-αlevels were significantly lower than that before treatment(P<0.05);there was no difference in PA-aO2between the two groups after treatment(P>0.05).After treatment,FVC,FEV1/FVC%,MVV%,PaO2and PaCO2in WLL group were higher than those in the conventional group,and IL-6 and TNF-αlevels were lower than those in the conventional group(P<0.05)Conclusion:WLL can significantly improve the lung function and blood gas index of pneumoconiosis patients,reduce the level of serum IL-6 and TNF-α,reduce the inflammatory reaction,and have a definite clinical effect,which is worthy of clinical application.