双肺同期大容量肺灌洗治疗煤工尘肺的方法学研究  

A Study on the Methodology of Simultaneous Massive Whole Lung Lavage in the Treatment of Coal Workers′ Pneumoconiosis

作　　者：高伟[1] 吴炬[1] 邱镞文 杨春民[1] 苟升东 李娟[1] 卢明章[1] 

机构地区：[1]攀枝花市第二人民医院呼吸职业病科,攀枝花617068

出　　处：《成都医学院学报》2017年第3期312-315,共4页Journal of Chengdu Medical College

摘　　要：目的探讨双肺同期大容量肺灌洗(MWLL)治疗煤工尘肺的方法学。方法选取2013年8月至2015年12月攀枝花市第二人民医院收治的成功行MWLL患者共39例,随机分为试验组(n=20)和对照组(n=19),试验组采用呼吸科自行研究设计的肺灌洗装置进行MWLL,在灌洗过程中于第3、6、9次引流末,进行加压通气、人工胸部震荡和交替负压吸引等"三合一"的复合方法治疗;对照组采用常规医用三通管组合的灌洗装置,灌洗过程中取消"三合一"复合方法。比较两组灌洗时间、灌洗液量和残留液量。采用健康调查简表(SF-36)评估MWLL对患者运动能力的影响。结果试验组双肺平均灌洗时间为(4.39±0.86)h,短于对照组(4.91±1.14)h(P<0.05);试验组双肺灌洗液总量少于对照组(P<0.05);试验组双侧残留液量少于对照组(P<0.05);10项运动能力指标中,除步行1 500m外,其余9项术后6个月较术前均有明显改善(P<0.05)。结论在MWLL术中使用自制肺灌洗专用装置,治疗效果良好,装置设计简单,操作方便,效果良好,且运动能力评估表来自SF-36健康调查表,具有一定科学性,对于评估MWLL的疗效有一定临床价值。Objective To study the methodology of simultaneous massive whole lung lavage（MWLL）to treat coal workers′pneumoconiosis.Methods The 39 patients administered successfully with MWLL in The Second People′s Hospital of Panzhihua from August of 2013 to December of 2015 were selected in the study and divided randomly into the experiment group（n=20）and the control group（n=19）.The self-designed lung lavage device was used in the experiment group and the triad composite therapy of pressurized ventilation,artificial chest shock and alternating pressure suction was used in the end of the third,sixth and ninth time of drainage respectively during the process of lavage;while the control group was treated with the conventional three-way tube without the triad composite therapy.Then the two groups were compared in lavage time,lavage fluid volume and residual fluid volume.The SF-36 health survey profile was adopted to evaluate the effect of MWLL on the exercise capacity of patients with pneumoconiosis.Results The average lavage time of both lungs in the experiment was（4.387±0.864）h,and it was significantly shorter than that in the control group which was（4.91±1.14）h.（P〈0.05）.The total lavage fluid volume and residual fluid volume of both lungs in the experiment group were significantly less than those in the control group respectively（P〈0.05）.All the indicators of the exercise capacity were significantly improved 6months after operation（P〈0.05）except the capacity of walking for 1500 meters in comparison with before operation.Conclusion The MWLL with the self-designed lung lavage device is effective with the advantages of simple design,convenient operation and good effect.The exercise capacity is assessed by the SF-36 health survey profile,so it is scientific to some extent and it has certain clinical value to evaluate the efficacy of MWLL.

关 键 词：双肺同期大容量肺灌洗 煤工尘肺 灌洗装置 运动能力 

分 类 号：R135.2[医药卫生—劳动卫生]