大容量肺灌洗治疗煤工尘肺肺功能远期效果观察.doc

大容量肺灌洗治疗煤工尘肺肺功能远期效果观察【摘要】 目的 通过对大容量肺灌洗(WLL)治疗煤工尘肺远期肺功能效果的分析,来探讨WLL治疗和控制尘肺病的效果。方法 选择陕西省韩城矿务局某煤矿,采用回顾性队列研究的方法,日本捷斯特(CHEST)肺功能仪作为检测仪器,对入列现存活的90例(肺灌洗组21例,非肺灌洗组69例)Ⅰ期煤工尘肺患者的肺功能进行横断面检测;将肺灌洗组和非肺灌洗组患者的肺功能按VC,FVC,FEV1,FEV1%,MMF,PEF,FEF25,FEF50,FEF75,MVV等10个指标进行比较分析。结果 肺灌洗组在PEF、FEF25及MVV指标检测结果分别为50.6±28.5,49.2±26.7,72.6±34.8;非肺灌洗组分别为30.8±16.2,30.8±17.3和 49.0±20.0,两组比较,肺灌洗组好于非肺灌洗组,差异有统计学意义(P0.05)。结论 WLL对尘肺患者的远期肺功能有一定的改善,是尘肺病治疗及二级预防的一种有效方法。 【关键词】大容量肺灌洗;肺功能;远期效果 【Abstract】Objective To analyse long-term therapeutic effects of large volume lung lavage on lung function of coal workers’pneumoconiosis, discuss treatment effect of WLL and pneumoconiosis. Methods Through retrospective cohort study, 90 existing patients with I stage coal worker’s pneumoconiosis from one coal mine of Hancheng Coal Mining Administration, Shaanxi Province were selected and divided into lung lavage group(21case ) and non-lung lavage grooup(69cases) .The lung functions of all patients were measured by Japan CEEST lung functional apparatus through cross-section study.Ten parameters such as VC,FVC,FEV1, FEV1%, MMF, PEF, FEF25, FEF50, FEF75 and MVV were compared and analyzed in two groups. Results PEF, FEF25 and MVV were (50.6±28.5),(49.2±26.7),(72.6±34.8) respectively in the lung lavage group,and (30.8±16.2),(30.8±17.3) and (49.0±20.0) respectively in the non-lung lavage group.These parameters in the lung lavage group were superior than that in the non- lung lavage group,there was statistical significance between them.There were no significant difference of other parameters between the two groups. Conclusion Large volume lung lavage can improve long-term lung function.It is an effective method for the treatment of pneumoconiosis and the second level prevention. 【Key words】 Large volume lung lavage;Lung function;Long-term effect 尘肺病是危害工人身体健康最严重的职业病。不仅影响国民经济的可持续发展,还可造成患者机体的伤残,导致其生活质量下降,一人患病全家贫困,进而影响社会安定。尘肺患者只能通过二、三级预防来减轻症状,减少并发症,提高生活质量。国家对尘肺患者的治疗研究分5个阶段[1],采取了多种治疗方法,目前推崇以WLL为主的综合治疗。我中心开展WLL至今已治疗尘肺病患者