大容量肺灌洗中肺泡表面活性物质自体回输临床观察  

Clinical abservations of pulmonary surfactant＇s autologous transfusion in massive lung lavage

作　　者：肖新宇[1] 张小平 陈刚[1] 袁扬[1] 马国宣[1] 段建勇[1] 孙志谦[1] 黄京慧[1] 曹兴[1] 张瑾[1] 

机构地区：[1]国家安全生产监督管理总局北戴河职业病防治院,秦皇岛066104 [2]华北理工大学

出　　处：《中华劳动卫生职业病杂志》2017年第1期11-14,共4页Chinese Journal of Industrial Hygiene and Occupational Diseases

摘　　要：目的探讨肺表面活性物质（pulmonary surfactant，PS）自体回输对肺灌洗患者呼吸功能恢复的影响，为临床应用提供理论依据。方法以接受大容量肺灌洗治疗的30例尘肺患者为观察对象。将第1次单肺灌洗后收集灌洗液提取PS，1周后在该患者第2次进行对侧肺灌洗后输入PS，将第1次灌洗侧肺设为未回输组，第2次灌洗的对侧肺设为回输组。观察PS自体回输前、术后0、60、90和120min呼气阻力、呼吸功、肺顺应性、气道压力、PO2、肺功能恢复时间等指标，比较PS回输前后肺功能变化。结果与未回输组比较，90、120min时回输组呼气阻力明显下降，60、90、120min时回输组呼吸功、气道压力明显下降，差异均有统计学意义（P〈0．05，P〈O．01）。与未回输组比较，在60、90、120min时回输组肺顺应性和PO：增加升高，差异有统计学意义（Pt0．05，P〈O．01）。回输组的肺功能恢复时间为（155．7±35．2）min，明显缩短于未回输组[（183．71±41．81）min]，差异有统计学意义（P〈0．05）。回输组心率、收缩压、舒张压等指标在灌洗后60、90、120min与未回输无明显差异，Ps自体回输后患者无肺不张、肺感染等不良反应的发生。结论PS自体回输能降低肺灌洗患者术后的呼气阻力、呼吸功、气道压力，提高肺顺应性和PO2，可以明显促进PS自体回输后肺功能恢复。Objective Investigate the pulmonary surfactant autotransfusion effect on the recovery of respiratory function in patients with whole lung lavage, to provide theoretical basis for the clinical application. Methods We taken 30 patients of pneumoconiosis treated by whole lung lavage as the subjects. We extracted the pulmonary surfactant from lavage fluid, after single postoperative lung lavage for the first time; after one weeks when the second times of lung lavage were performed to the other side of the lung of patients, we put PS into the right side. We taken the patients the second times of lung lavage who were put PS into the right side as returning group, the first times of lung lavage who were not put PS into as on returning group. We observed indicators, such as expiratory resistance, respiratory work, lung compliance, airway pressure, PO2, the pulmonary function recovery time and other indicators, comparing with the changes of pulmonary function before lung lavage for the first time and at 0,60,90,120 min after the pulmonary surfactant autotransfusion. Results Compared with the no returning group, the expiratory resistance of the returning group decreased significantly at 90 rain,120 min after the pulmonary surfactant autotransfusion; the respiratory work and airway pressure of the returning group decreased significantly at 60,90,120 rain after the pulmonary surfactant autotransfusion, there was statistically significant in the difference between different groups （P〈0.05 ,P〈0.01 ）. Compared with the no returning group, the lung compliance and the PO2 of the returning group increased significantly at 60 min,90 min, 120 min after the pulmonary surfactant autotransfusion, there was statistically significant in the difference between different groups （P〈0.05, P〈0.01 ）. The lung function recovery time of returning group was （155.7＋_35.2） rain, the lung function recovery time of no returning group was （183.71 ±41.81 ） min, there was statistically significant in the difference between dif

关 键 词：尘肺 支气管肺泡灌洗 肺泡表面活性物质 呼吸功能试验 

分 类 号：R135.2[医药卫生—劳动卫生]