小容量支气管肺泡灌洗联合无创呼吸机治疗尘肺合并症的疗效观察

Observation on clinical efficacy of mini-bronchoalveolar lavage combined with non-invasive ventilator in the treatment of complications of pneumoconiosis

目的观察小容量支气管肺泡灌洗联合无创呼吸机治疗尘肺合并症的疗效。方法选择韶关市职业病防治院2018年6月至2020年6月治疗的600例男性尘肺患者纳入本次研究。按照随机数字表对照法分为两组,每组各300例。对照组采用单纯小容量支气管肺泡灌洗治疗,观察组采用小容量支气管肺泡灌洗联合无创呼吸机治疗。观察两组患者治疗10 d后临床疗效,并比较患者灌洗前后临床症状(胸闷、胸痛、气促)改善情况、肺功能指标[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、最大通气量(MVV)]检测结果变化情况以及生存质量情况。结果观察组的总有效率为94.33%,高于对照组的87.33%,差异有统计学意义(P<0.05);观察组患者灌洗后胸闷、胸痛、气促症状例数低于对照组,差异有统计学意义(P<0.05);观察组患者灌洗后FEV1、FVC、MVV检测结果均高于对照组,差异有统计学意义(P<0.05);观察组患者灌洗后生理功能评分、生理职能评分、躯体疼痛评分、情感职能评分、心理健康评分、社会功能评分、活力评分、总体健康评分均高于对照组,差异有统计学意义(P<0.05)。结论小容量支气管肺泡灌洗联合无创呼吸机治疗尘肺合并症疗效显著,能够明显改善患者肺功能和生存质量,值得临床推荐。

Objective To observe the efficacy of mini-bronchoalveolar lavage(mini-BAL)combined with noninvasive ventilator in the treatment of complications of pneumoconiosis.Methods A total of 600 male patients treated in Shaoguan Occupational Disease Prevention and Control Hospital from June 2018 to June 2020 were included in this study.According to the random number table method,they were divided into two groups,with 300 cases in each group.The control group was treated with mini-BAL.The observation group was treated with mini-BAL combined with the non-invasive ventilator.The clinical efficacy of two groups p ten days after treatment was observed,and the improvement of clinical symptoms(chest tightness,chest pain and shortness of breath),changes in pulmonary function indicators[forced expiratory volume in one second(FEV1),forced vital capacity(FVC)and maximum ventilatory volume(MVV)]and changes in quality of life(QOL)were compared before and after lavage.Results The total effective rate was higher in the observation group(94.33%)than that in the control group(87.33%),with statistically significant difference(P<0.05).The proportion of patients with chest tightness,chest pain and shortness of breath after lavage was lower in the observation group than that in the control group,with statistically significant difference(P<0.05).FEV1,FVC and MVV were higher in the observation group after lavage than those in the control group,and the differences were statistically significant(P<0.05).The scores of physiological function,physiological function,somatic pain,emotional function,mental health,social function,vitality and general health were higher in the observation group than those in the control group after lavage,with statistically significant differences(P<0.05).Conclusion The mBAL combined with non-invasive ventilator is effective in the treatment of complication of pneumoconiosis,which can significantly improve the pulmonary function and QOL of patients.Thus,it is worthy of clinical application.