灌洗液加入沙丁胺醇和地塞米松治疗尘肺的效果  

Therapeutic efficacy of saibutamoi and dexamethasone added into whole lung lavage fluid in patients with pneumoconiosis

作　　者：朱建勇[1] 曾玉琴[2] 陈功[1] 邝军[1] 张立波[1] 王永兰[1] 

机构地区：[1]湖北医药学院附属人民医院呼吸内科,湖北十堰442000 [2]湖北医药学院附属人民医院附属太和医院内分泌科,湖北十堰442000

出　　处：《中华劳动卫生职业病杂志》2013年第5期383-385,共3页Chinese Journal of Industrial Hygiene and Occupational Diseases

摘　　要：目的探讨在尘肺患者大容量全肺灌洗液中加入沙丁胺醇、地塞米松的临床疗效及安全性。方法将176名尘肺患者随机分为对照组（86例）和治疗组（90例），对照组常规用0．9％氯化钠溶液灌洗；治疗组在每侧肺第1、4次灌洗液中加入沙丁胺醇和地塞米松。将两组灌洗前后的肺部哮鸣音、动脉氧分压（PaO2）、气道峰压，肺内残液量和72h后的第1秒用力呼气容积（FEV1.0）、一氧化碳弥散量（DLco）及用力肺活量（FVC）进行比较。结果与对照组（29．1％）比较，术后治疗组的肺部哮鸣音检出率（13.3％）降低，差异有统计学意义（X^2=5．028，P=0．025）。灌洗后对照组新发生哮呜音的比例（21．8％）明显高于治疗组（3．7％），对照组相对于治疗组诱发哮呜音的OR值为5．423（95％CI为2．036～9．568）。与对照组比较，灌洗后治疗组PaO2升高，气道峰压降低，肺内残液量减少，差异均有统计学意义（t=2．163～4．132，P〈0．05）。灌洗后治疗组FEV1.0、DLco及FVC明显高于对照组，差异有统计学意义（f=1．986～2．345，P〈0．05）。结论大容量全肺灌洗液中加入沙丁胺醇、地塞米松可以有效缓解尘肺患者的支气管痉挛，减轻低氧向痒．降低与道峰乐．促讲术后月市功能的恢每。Objective To investigate the therapeutic efficacy and safety of salbutamol and dexamethasone added into large-volume whole lung lavage （WLL） fluid in patients with pneumoconiosis. Methods A total of 176 patients with pneumoeoniosis were randomly divided into control group （n=86） and treatment group （n=90）. The control group received WLL with 0.9% sodium chloride solution, while for the treatment group, salbutamol and dexamethasone were added into the WLL fluid for both lungs at the 1st and 4th WLLs. Before and after WLL, the puhnonary wheezing, arterial partial pressure of oxygen （PaO2）, peak airway pressure （Pa peak）, amount of intrapuhnonary residual fluid, forced expiratory volume in one second （FEV 1.0） （72 h later）, diffusion capacity for carbon monoxide （DLCO）, and forced vital capacity （FVC） were measured for comparison between the two groups. Results After WLL, the treatment group had a significantly lower detection rate of pulmonary wheezing than the control group （ 13.3% vs 29.1%, X^2=5.028, P=0.025）, and the control group had a significantly higher incidence rate of pulmonary wheezing than the treatment group （21.8% vs 3.7%, OR=5.423, 95%C1 2.036-9.568）. Compared with the control group, the treatment group had significantly higher PaO2 and significantly lower Pa peak and amount of intrapulmonary residual fluid （t =2.163-4.132, P〈0.05） and significantly higher FEVI, DLCO, and FVC （t=1.986-2.345, P〈0.05） after WLL. Conclusion Salbutamol and dexamethasone added into large-volume WLL fluid may effectively alleviate bronchial spasm, reduce hypoxemia, and decrease Pa peak in patients with pneumoconiosis, thus promoting lung function recovery after WLL.

关 键 词：尘肺 支气管肺泡灌洗 沙丁胺醇 地塞米松 

分 类 号：R563.9[医药卫生—呼吸系统]