同期双侧序贯全肺灌洗治疗肺泡蛋白沉积症10例分析  

Bilateral sequential whole lung lavage in the same treatment session for pulmonary alveolar proteinosis

作　　者：谢世光[1] 蔡柏蔷[1] 张弘[1] 留永健[1] 柳涛[1] 

机构地区：[1]中国医学科学院 中国协和医科大学 北京协和医院呼吸内科,100730

出　　处：《中华内科杂志》2007年第2期118-122,共5页Chinese Journal of Internal Medicine

摘　　要：目的总结全麻下同期双侧序贯全肺灌洗治疗肺泡蛋白沉积症(PAP)的经验。方法回顾性分析2003年4月至2005年12月北京协和医院呼吸内科对10例 PAP 患者在全麻下行同期双侧序贯全肺灌洗的病例资料。结果 10例 PAP 患者共行12例次同期双侧序贯全肺灌洗,过程顺利,每次总灌人液量为(26417±7064)ml,总回收液量为(25962±7023)ml,持续时间(192±26)min。1例患者灌洗后出现肺水肿。10例患者灌洗后临床症状及胸部影像学改变有改善;肺泡动脉氧分压差下降,与灌洗前比较差异有统计学意义;PaO_2升高,与灌洗前比较差异无统计学意义;短期内10例患者的肺功能无明显变化。结论同期双侧序贯全肺灌洗是目前治疗 PAP 安全有效的方法。Objective To study the safety and effectiveness of bilateral sequential whole lung lavage in the same treatment session for pulmonary alveolar proteinosis. Methods Twelve times bilateral sequential whole lung lavage in the same treatment session were performed under general anaesthesia using a double lumen endotracheal tube for 10 cases of pulmonary alveolar proteinosis. The volume of lavage, return volume and the return rate were calculated. The efficacy was evaluated according to the improvement of symptoms, pulmonary function and arterial blood gas analysis data. Results Twelve times bilateral sequential whole lung lavage in the same treatment session were performed successfully for the 10 cases of pulmonary alveolar proteinosis. The total volume of lavage was （26 417 ± 7 064 ）ml, the return volume was （25 962 ± 7 023 ） ml,the time of lavage was （192 ± 26 ）minutes. The symptoms and chest radiograph were improved immediately after the procedure for all patients. The alveolar to arterial oxygen tension difference was decreased significantly. Arterial oxygen tensions were increased but no significant difference was reached. There was no significant immediate improvement for the pulmonary function. No complications were noted but pulmonary edema in one patient. Conclusion Bilateral sequential whole lung lavage in the same treatment session is a safe and effective procedure for treatment of pulmonary alveolar proteinosis.

关 键 词：肺泡蛋白沉积症 肺灌洗 同期双侧序贯治疗 回顾性分析 

分 类 号：R563.9[医药卫生—呼吸系统]