大容量肺灌洗联合N-乙酰半胱氨酸治疗尘肺病的效果

Efficacy of large-volume lung lavage combined with N-acetylcysteine in the treatment of pneumoconiosis

目的探讨大容量肺灌洗联合N-乙酰半胱氨酸治疗尘肺病的效果。方法抽取中国平煤神马集团职业病防治院2018年2月至2019年7月收治的100例尘肺病患者,为全部患者及其家属讲解尘肺病不同治疗方案,根据患者及家属选择的治疗方案分组,其中48例选择常规+N-乙酰半胱氨酸治疗的患者作为对照组,52例选择常规治疗+大容量肺灌洗+N-乙酰半胱氨酸治疗的患者纳入观察组。治疗前、治疗6个月时,检测并比较两组肺功能如第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、最大通气量(MVV)、第一秒用力呼气量占用力肺活量比例(FEV1 /FVC)指标;检测两组炎性因子指标如白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、血气指标[血二氧化碳分压(PCO2)、动脉氧分压(PO2);治疗期间,记录两组不良反应发生情况。结果治疗6个月后,两组FEV1、FVC、FEV1/FVC、MVV均高于治疗前,且观察组高于对照组(P<0.05);治疗6个月后,两组IL-6、TNF-α水平均低于治疗前,且观察组低于对照组(P<0.05);治疗6个月后,两组PCO2低于治疗前,PO2高于治疗前,且观察组PCO2低于对照组,PO2高于对照组(P<0.05);两组不良反应发生率相近(P>0.05)。结论大容量肺灌洗联合N-乙酰半胱氨酸治疗尘肺病,可有效改善患者的肺功能及血气指标,减少炎性因子分泌,更利于减轻全称炎症反应程度,且治疗期间不会增加不良反应,安全可靠,有较高的临床应用价值。

Objective To observe the effect of large-volume lung lavage combined with N-acetylcysteine in the treatment of pneumoconiosis.Methods A total of 100 pneumoconiosis patients who were treated in China Pingmei Shenma Group Occupational Disease Prevention Hospital from February 2018 to July 2019 were selected,the different treatment options for pneumoconiosis were explained for all patients and their families.According to the selection of treatment plans for patients and their families,48 of them who selected routine+N-acetylcysteine for treatment were served as a control group,and 52 patients who selected conventional treatment+large-volume lung lavage+N-acetylcysteine treatment were included in the observation group.Before and at 6 months of treatment,the lung function such as forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC),maximum ventilation(MVV),proportion of forced expiratory volume in the first second occupying force vital capacity(FEV1/FVC)indicators of the two groups were detected and compared;the inflammatory factor indicators such as interleukin(IL-6),tumor necrosis factor-α(TNF-α),blood gas indicators detected blood carbon dioxide partial pressure(PCO2),arterial oxygen such as partial pressure(PO2)of the two groups were detected;during treatment,the occurrence of adverse reactions in both groups were recorded.Results After 6 months of treatment,both were detected groups of FEV1,FVC,FEV1/FVC and MVV were higher than those before treatment,and those in the observation group were higher than those in the control group(P<0.05);after 6 months of treatment,the levels of IL-6 and TNF-αin the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group(P<0.05);after 6 months of treatment,PCO2 in the two groups was lower than that before treatment,PO2 was higher than that before treatment,and PCO2 in the observation group was lower than that in the control group,and PO2 was higher than that the control group(P<0.05);the incidence of adverse reactions was similar between the two groups(P>0.05).Conclusions Large volume lung lavage combined with N-acetylcysteine on pneumoconiosis,can effectively improve the patients’lung function and blood gas indexes,reduce the secretion of inflammatory factors,and it is more conducive to reducing the degree of full-length inflammatory response,and does not increase adverse reactions during treatment.It is safe and reliable,and has high clinical application value.