大容量肺灌洗对尘肺患者肺功能及运动能力的影响  

Effects of whole lung lavage on pulmonary function and exercise capacity in patients with pneumoconiosis

作　　者：周韶炜[1] 毛翎[1] 刘锦铭[2] 杨文兰[3] 施瑾[1] 张悦[1] 卞陆琴[1] 

机构地区：[1]同济大学附属上海市肺科医院肺尘肺科,上海200433 [2]同济大学附属上海市肺科医院呼吸科,上海200433 [3]同济大学附属上海市肺科医院肺功能室,上海200433

出　　处：《中华劳动卫生职业病杂志》2013年第6期428-431,共4页Chinese Journal of Industrial Hygiene and Occupational Diseases

摘　　要：目的探讨大容量肺灌洗对尘肺患者肺功能和运动能力的影响。方法选择脱离粉尘作业不超过6个月的尘肺患者41例进行全肺大容量肺灌洗（WLL），对灌洗前和灌洗后1周的临床症状、静态肺功能（PVT）和心肺运动试验（CPET）结果进行比较。结果灌洗前后临床症状无明显差异。灌洗后1周用力肺活量（FVC）、第1秒用力呼气容积（FEV10）和第1秒用力呼气容积占预计值百分比（FEV10％）有所上升，但差异无统计学意义（P〉0．05）。灌洗后峰值摄氧量从（2140．6±353．2）ml／min上升到（2374．6±362．4）ml／min，峰值摄氧量占预计值百分比从（82．2％＋13．7％）上升到（91．0％±14．0％），峰值公斤摄氧量从（30．6±3．5）ml／min上升到（34．2±3．7）ml／min，二氧化碳通气当量最低值从（30．6±3．1）上升至（26．1±2．7），差异有统计学意义（P〈0．05）。结论WLL术能使尘肺患者运动状态时的摄氧能力和通气效率显著提高，从而提高运动能力。Objective To investigate the effects of whole lung lavage （WLL） on the pulmonary function and exercise capacity in patients with pneumoconiosis. Methods Forty-one patients with pneumoconiosis who quit dust-exposed work not more than 6 months before underwent WLL. Clinical symptom assessment, pulmonary function test, and cardiopulmonary exercise test were performed before and one week after WLL, and the results were compared. Results The patients with pneumoeoniosis showed no significant changes in clinical symptoms after WLL. At one week after WLL, the patients with pneumoconiosis showed nonsignificant increases in forced vital capacity, forced expiratory volume in one second （FEV10）, and percent predicted FEV1 （P〉O.05）; peak oxygen uptake （peak VO2） increased from 2140.6±353.2 ml/min before WLL to 2374.6±362.4 ml/min after WLL, percent predicted peak V02 inereased from 82.2±13.7% before WLL to 91.0±14.0% after WLL, peak VO2/kg increased from 30.6±3.5 ml/min-kg before WLL to 34.2±3.7 ml/min .kg after WLL, and ventilatory equivalent for carbon dioxide decreased from 30.6±3.1 before WLL to 26.1±2.7 after WLL （P〈O0.05）. Conclusion WLL can remarkably improve the oxygen uptake and ventilatory efficiency in patients with pneumoconiosis during exercise, so it ean improve the exercise capacity of these patients.

关 键 词：尘肺病 全肺大容量肺灌洗 肺功能 心肺运动试验 

分 类 号：R135.2[医药卫生—劳动卫生]