经支气管镜大容量肺灌洗治疗尘肺病合并慢性阻塞性肺疾病的疗效分析*

Therapeutic efficacy of large volume broncholavage by bronchonscopy for pneumoconiosis complicated with chronic obstructive pulmonary disease*

摘要:

摘要：目的 评价经支气管镜大容量肺灌洗对尘肺病合并慢性阻塞性肺疾病（COPD）患者的临床症状及肺功能的改善作用。方法 103例尘肺病合并COPD患者随机分为治疗组54例，给予经支气管镜大容量肺灌洗治疗，对照组49例。观察患者治疗前、治疗后12、24和48周运动耐量、呼吸困难评分、6 min步行试验距离（6MWD）、圣乔治问卷评分（SGRQ）以及肺功能变化。并记录灌洗时的不良反应。结果 两组患者第12、24和48周医学研究委员会（MRC）呼吸困难评分均较治疗前下降（P <0.05），但治疗组较对照组下降更明显（P <0.05）；治疗组各时点6MWD值较前明显增加，SGRQ较治疗前下降，差异均有统计学意义（P <0.05），而对照组有所改善，但与治疗前比较差异无统计学意义（P >0.05）；治疗组中各项指标较对照组改善（P <0.05）。治疗组12、24和48周用力肺活量（FVC）、第1秒用力肺活量（FEV1）均较治疗前明显增加（P <0.05）；对照组与治疗前比较无差异，治疗组肺功能改善优于对照组（P <0.05）。结论 经支气管镜大容量肺灌洗治疗尘肺病合并COPD安全、有效，值得临床推广。

Abstract:

Abstract: Objective To observe the therapeutic efficacy and safety of large volume broncholavage by bronchonscopy in treatment of pneumoconiosis complicated with chronic obstructive pulmonary disease (COPD). Methods 103 patients with pneumoconiosis complicated with COPD were randomly divided into treatment group (n = 54) and control group (n = 49). The treatment group was treated with large volume broncholavage by bronchonscopy. The dyspnea score of medical research council scale (MRC), six-minute walk distance and the St. George’s Respiratory Questionnaire (SGRQ) and lung function (FEV1 and FVC) were measured before and 12, 24, 48 weeks after the treatment respectively. Results 12, 24, 48 weeks after the treatment, the MRC score in both groups were decreased than before treatment but which was better in the treatment group. There were improvements of 6 minute walk test, and the SGRQ score after the treatment, and which was better in the treatment group. Compared with baseline and the control group, significantly greater improvements in the FVC, FEV1 were seen in the treatment group at all the time points. There was no significant difference for the control group. Conclusion Large volume broncholavage through bronchonscopy is an effective and safe treatment on pneumoconiosis complicated with COPD.