11例合并肺大泡患者行高压氧治疗的安全性分析  

Analysis on the safety of hyperbaric oxygen therapy in 11 patients with complicated pulmonary bullae

作　　者：姜晨 孙超[1] 姜萍[2] 黄盈 林苏杰 Jiang Chen;Sun Chao;Jiang Ping;Huang Ying;Lin Sujie(Department of Hyperbaric Oxygen,Qingdao Hospital,University of Health and Rehabilitation Science(Qingdao Municipal Hospital),Qingdao 266000,China;Fever Clinic,Qingdao Hospital,University of Health and Rehabilitation Science(Qingdao Municipal Hospital),Qingdao 266000,China;Department of General Practice,Qingdao Hospital,University of Health and Rehabilitation Science(Qingdao Municipal Hospital),Qingdao 266000,China;First Department of Respiratory and Critical Care Medicine,Qingdao Hospital,University of Health and Rehabilitation Science(Qingdao Municipal Hospital),Qingdao 266000,China)

机构地区：[1]康复大学青岛医院(青岛市市立医院)高压氧科,青岛266000 [2]康复大学青岛医院(青岛市市立医院)发热门诊,青岛266000 [3]康复大学青岛医院(青岛市市立医院)全科医学科,青岛266000 [4]康复大学青岛医院(青岛市市立医院)呼吸与危重症医学一科,青岛266000

出　　处：《中华航海医学与高气压医学杂志》2023年第2期201-205,共5页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的探讨合并肺大泡患者行高压氧治疗的安全性。方法回顾性分析2019年10月至2021年10月期间青岛市市立医院高压氧科收治的11例合并肺大泡患者行高压氧治疗的临床资料及治疗过程,并对高压氧治疗的安全性进行分析评估。结果胸部CT提示11例患者中有7例为多发肺大泡,数量最多者超过20个。直径超过30 mm者有4例,最大者直径可达55 mm,且位于近胸膜处。在合并肺部疾病方面,5例患者合并慢性支气管炎、双肺肺气肿,其中1例还同时合并双肺间质纤维化;另有1例合并双肺肺气肿、支气管扩张,1例合并陈旧性肺结核、薄壁空洞形成。在治疗压力0.2 MPa(2.0 ATA)、减压时间至少20 min的治疗方案下,所有患者在中位治疗次数6(2,13)次的治疗期间均未出现突发咳嗽、胸闷、胸痛、咯血以及呼吸困难等症状。结论进舱治疗前对合并肺大泡患者完善胸部CT检查是十分必要的。在相对较低的治疗压力并延长减压时间的治疗方案下,合并肺大泡患者行高压氧治疗是相对安全的。Objective To investigate the safety of hyperbaric oxygen(HBO)therapy in patients with pulmonary bullae.Methods The clinical data and treatment process of 11 patients with pulmonary bullae treated in the Department of Hyperbaric Oxygen of Qingdao Municipal Hospital from October 2019 to October 2021 were analyzed retrospectively,and the safety of HBO treatment was analyzed and evaluated.Results Chest CT suggested multiple pulmonary bullae in seven out of the 11 patients,with the maximum number over 20 in one case.The diameter of bullae in four cases exceeded 30 mm,with the largest one exceeding 55 mm and close to the pleura.In terms of complicated pulmonary diseases,five patients were complicated with chronic bronchitis and emphysema in both lungs;one of them was also complicated with interstitial fibrosis of both lungs;one was complicated with emphysema in both lungs and bronchiectasis;and one was complicated with old pulmonary tuberculosis and thin-walled cavities.With the treatment scheme of the pressure of 0.2 MPa(2.0 ATA)and at least 20 min of decompression,no patient showed sudden cough,chest tightness,chest pain,hemoptysis,or dyspnea during six[median of(2,13)]times of treatment.Conclusion It is necessary to carry out chest CT examination for patients with complicated pulmonary bullae before entering HBO cabin.With relatively low HBO pressure and prolonged decompression time,HBO therapy is relatively safe for patients with pulmonary bullae.

关 键 词：肺大泡 高压氧 安全性 

分 类 号：R563[医药卫生—呼吸系统]