大容量全肺灌洗术对尘肺病合并慢性阻塞性肺疾病的疗效分析  

Effect of large volume whole lung lavage on pneumoconiosis complicated with chronic obstructive pulmonary disease

作　　者：朱佑明 甘易玲 夏薇 刘小媛 陈涵 ZHU You-ming;GAN Yi-ling;XIA Wei(Department of Respiration Medicine, Chongqing Hospital of Occupation Disease Prevention and Care, Chongqing 400060, China.)

机构地区：[1]重庆市职业病防治院呼吸内科,重庆400060

出　　处：《临床和实验医学杂志》2017年第23期2326-2329,共4页Journal of Clinical and Experimental Medicine

基　　金：重庆市基础与前沿研究计划项目(cstc2014jcyj A10121)

摘　　要：目的探讨大容量全肺灌洗术对尘肺病合并慢性阻塞性肺疾病(COPD)患者肺通气功能的影响。方法选取2014年3月至2017年6月收治的76例尘肺病合并COPD患者进行回顾性研究,其中36例患者采用大容量全肺灌洗术治疗作为观察组,40例患者采用小容量灌洗术进行治疗作为对照组。对比两组患者治疗前后血清转化生长因子-β1(TGF-β1)和肿瘤坏死因子-α(TNF-α)水平变化,同时对比两组患者治疗前后肺功能、生活质量评分以及6 min步行距离等。结果经治疗后,两组患者TGF-β1、TNF-α水平均显著下降,但观察组患者的下降程度更显著(P<0.05);治疗后,两组患者第一秒用力呼气容积(FEV1)、用力肺活量(FVC)和FEV1/FVC等指标均显著优于治疗前(P<0.05),且观察组患者的肺功能各指标均显著优于对照组(P<0.05);观察组患者治疗后生活质量评分和6 min步行距离分别为[(46.67±5.69)分]、[(374.54±26.84)m],对照组患者各指标水平分别为[(53.68±4.69)分]、[(302.53±24.23)m],观察组改善效果显著优于对照组,差异有显著性(P<0.05)。结论尘肺病合并COPD患者采用大容量全肺灌洗术进行治疗可以有效的改善患者体内炎症因子水平,改善患者的肺功能,提高患者的生活质量,促进患者康复,效果显著,值得临床推广。ObjectiveTo investigate the effect of massive lung lavage on pulmonary ventilation in patients with pneumoconiosis complicated with chronic obstructive pulmonary disease(COPD).MethodsA retrospective analysis of76patients with pneumoconiosis and COPD from March2003to June2017was retrospectively performed.Among them,36patients were treated with large volume whole lung lavage as observation group and40patients with small capacity lavage were treated as a control group.(TGF-β1)and tumor necrosis factor-α(TNF-α)levels were measured before and after treatment,and the lung function,quality of life score and6-minute walking volume were compared between the two groups before and after treatment.ResultsAfter treatment,the levels of TGF-β1and TNF-αin the two groups were significantly lower than those in the observation group(P<0.05).After treatment,the levels of FVC,FEV1and FEV1/FVC were significantly better than those before treatment(P<0.05),and the lung function of the observation group was significantly better than that of the control group(P<0.05)(46.67±5.69)points,[(374.54±26.84)m],and the control group had the mean levels of[(53.68±4.69)points],[(302.53±24.23)m],the difference between the two groups was significant(P<0.05).ConclusionThe treatment of pneumoconiosis with COPD patients with large volume of lung lavage can effectively improve the level of inflammatory factors,lung function and quality of life of patients,promote patient rehabilitation.The effect is remarkable,which is worthy of clinical promotion.

关 键 词：尘肺病 慢性阻塞性肺疾病 大容量灌洗术 

分 类 号：R135.2[医药卫生—劳动卫生]