大容量全肺灌洗治疗尘肺合并慢性阻塞性肺疾病.docVIP

医学论文免费下载 大容量全肺灌洗治疗尘肺合并慢性阻塞性肺疾病 　　作者：涂明利1, 刘玉全1, 雷怀定1, 刘先军1, 秦成名2, 王贤裕2, 全守波2 作者单位：(郧阳医学院附属太和医院1呼吸内科;2麻醉科,湖北 十堰 442000) 　　【摘要】 目的：探讨大容量全肺灌洗治疗尘肺合并慢性阻塞性肺疾病(COPD)患者的安全性和疗效。方法：35例尘肺合并COPD患者，采用双腔气管插管、静脉复合麻醉、单肺通气双肺通气交替，行大容量单侧肺灌洗术，1周后再灌洗对侧肺。监测生命体征和动脉血气，检测肺功能指标的变化情况。结果：35例患者共接受全肺灌洗术70次，术中出现一过性哮鸣音和一过性低氧血症各7例次(10%),未出现其他并发症,有效率100%。术后2周肺通气和换气功能明显好转、症状缓解，至少持续6月。结论：严格的术前肺功能评估和术中单肺双肺交替通气下大容量全肺灌洗治疗尘肺合并COPD安全有效。 　　【关键词】 尘肺;慢性阻塞性肺疾病;全肺灌洗;治疗 　　Large Volume Whole Lung Lavage for Treatment of Pneumoconiosis Patients Complicated by Chronic Obstructive Pulmonary Disease TU Mingli1,LIU Yuquan1,LEI Huaiding1,LIU Xianjun1,QIN Chengming2,WANG Xianyu2,QUAN Shoubo2 (1Department of Respiratory Diseases，2Department of Anesthesiology,Taihe Hospital,Yunyang Medical College,Shiyan，Hubei 442000,China) 　　Abstract: Objective To explore the safety and efficacy of massive whole lung lavage(MWLL) for treatment of pneumoconiosis patients complicated by chronic obstructive pulmonary disease. Methods Under double cavity intubation, intravenous combined anesthesia,alternate one and two lung ventilation,massive single lung lavage were performed on 35 cases of pneumoconiosis patients complicated by COPD.The opposite lung lavage were performed in the same way after one week.The vital signs and arterial blood gas were monitored,and the change of lung function index were detected.Results In total,70 times of MWLL were performed on 35 patients,in which transient wheezing rale and transient hypoxemia happened 7 times (10%),respectively.The effective rate was 100% and there was no complication.After 2 weeks the function of pulmonary ventilation was markedly improved,symptoms were alleviated obviously and last for at least 6 months. Conclusion With strictly preoperative evaluation of pulmonary function and intraoperative alternate one and two lung ventilation,MWLL is safe and effective for the treatment of pneumoconiosis patients complicated by COPD. 　　Key words: Pneumoconiosis;Chronic ob