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目的探讨改良大容量全肺灌洗术(WLL)治疗尘肺的临床效果及安全。方法按随机数字表进行抽样,32例二期或三期尘肺病患者行分侧WLL,采用患者自身左右肺配对对照研究。治疗侧肺(治疗组)采用改良WLL,即共灌洗9次,在灌洗第2、4、6、8次末经气管导管注入复方异丙托溴铵后再行加压通气,灌洗第9次末行加压通气,每次加压通气时鼓肺6次。对侧肺(对照组)采用常规WLL,即共灌洗12次,在灌洗第3、6、9、12次末行加压通气,每次加压通气时鼓肺4次。比较两组的灌洗时间、灌洗液的残留量、灌洗出的粉尘含量、术中及术后并发症、费用。结果治疗组灌洗时间、灌洗液的残余量及费用均少于对照组(P<0.01);治疗组的粉尘含量明显多于对照组(P<0.01);两组术中及术后并发症比较差异无统计学意义。结论与WLL比较,改良WLL治疗尘肺病能获得更好的临床效果。
Objective To investigate the clinical effect and safety of modified large-volume whole lung lavage (WLL) in the treatment of pneumoconiosis. Methods According to the random number table, 32 patients with stage II or stage III pneumoconiosis underwent side-to-side WLL, using the patients’ own left and right lung matched controls. The treatment side of the lung (treatment group) using modified WLL, that is, a total of lavage nine times, at the end of 2,4,6,8 after lavage intratracheal injection of compound ipratropium bromide pressurized ventilation, lavage The end of the ninth line of pressurized ventilation, each time the ventilation of the lungs 6 times. Contralateral lung (control group) using conventional WLL, that is, a total of 12 lavages irrigation, lavage the end of the 3rd, 6th, 9th and 12th episodes of ventilation, each time the lungs under pressure ventilation 4 times. The lavage time, the amount of lavage fluid, the amount of lavage dust, intraoperative and postoperative complications and costs were compared between the two groups. Results The lavage time, the residual volume of lavage fluid and the cost of the treatment group were less than those of the control group (P <0.01). The dust content of the treatment group was more than that of the control group (P <0.01). The intraoperative and postoperative complications The difference was not statistically significant. Conclusion Compared with WLL, improved WLL treatment of pneumoconiosis can get better clinical results.