肺灌洗结合肺内给药防治煤工尘肺患者肺部炎症初探  

Effects of bronchoalveolar lavage therapy combined with instillation of antibiotics and immunomodulator on silicotic pulmonary inflammation

作　　者：邹伟明[1] 李和林[1] 黄曙海[1] 李开荣[2] 廖瑞庆[1] 汤俊豪[1] 

机构地区：[1]广西职业病防治研究所,广西南宁530021 [2]广西合山矿务局职工医院,546508

出　　处：《中国职业医学》2005年第2期34-36,共3页China Occupational Medicine

基　　金：广西自然科学基金(桂科自0135029)

摘　　要：目的观察肺灌洗联合肺内应用抗生素和免疫调节剂防治煤工尘肺肺部炎症和感染的效果。方法选择某煤矿接尘工人、煤工尘肺患者,进行肺灌洗治疗,并在灌洗过程中肺内直接给予抗生素以及免疫调节剂。观察肺灌洗液沉渣和灰分,治疗前后肺灌洗液中白蛋白、免疫球蛋白含量、肺通气功能以及X线胸片尘肺影像变化。结果治疗后Ⅱ期煤工尘肺患者呼吸道自觉症状减轻,肺灌洗液白蛋白、IgG明显低于第1次灌洗,肺通气功能改善;煤工尘肺患者X线胸片纹理变清晰、部分患者尘肺小阴影密集度减轻。结论肺灌洗联合肺内抗生素、免疫调节剂应用对防治患者肺部炎症,延缓尘肺病变可能有积极作用。Objective To evaluate the bronchoalveolar lavage therapy combined with instillation of both antibiotics and immunomodulator on silicotic pulmonary inflammation. Methods 54 coal workers and patients with grade 0+, Ⅰ, or Ⅱ of coal worker’s pneumoconiosis (CWP) were enrolled to the clinic trial by the way of bronchoalveolar lavage and instillation of both antibiotics and immunomodulator via bronchofiberscope. Effects were assessed by comparison on the indices of albumin, IgG and IgA in bronchoalveolar lavage fluid (BALF), pulmonary respiratory function, and changes in the chest radiographs. Results The contents of albumin and IgG in BALF of patients with CWP after several courses of treatment were lower than those after first lavage and pulmonary respiratory function FVC improved. Chest radiographs showed decreased peripheral and bronchovascular shadows in most cases and ILO profusion category nodular interstitial changes in two cases of CWP. Most of the patients felt subjective respiratory symptoms alleviated after the treatment. Conclusion Bronchoalveolar lavage in combination with pulmonary instillation of both antibiotics and immunomodulator might help removing mineral dust and inflammatory factors from the lung, limiting the rate of disease progress.

关 键 词：煤工尘肺 肺灌洗 炎症 免疫调节 

分 类 号：R135.2[医药卫生—劳动卫生]