CAJ | 학술논문

目的探讨尘肺观察对象和Ⅰ期煤工尘肺患者行大容量肺灌洗术后再次从事接触粉尘工作,对其临床症状及动脉血气分析、肺功能的影响.方法选择在准北矿业集团职业病防治院行大容量肺灌洗手术的尘肺观察对象及Ⅰ期煤工尘肺患者,术后再接尘者为术后接尘组(86例),术后不再接尘者为灌洗对照组(86例);以其同班组年龄、接尘史、接尘种类大致相同的工友作为未灌洗对照组(86例).分别在术后接尘组和灌洗组常规灌洗接受大容量肺灌洗术前、灌洗术后1个月及灌洗后1年时随访临床症状及动脉血气分析、肺功能等指标.结果术后1个月,术后接尘组和灌洗对照组临床表现评分明显低于术前和未灌洗对照组,差异有统计学意义(P＜0.01).术后1年,术后接尘组和灌洗对照组临床表现评分明显低于术前,未灌洗对照组临床表现评分明显高于术后接尘组和灌洗对照组,灌洗对照组临床表现评分明显低于术后接尘组,差异均有统计学意义(P＜0.01).术后1个月,术后接尘组和灌洗对照组动脉血氧分压明显高于术前水平和未灌洗对照组,差异有统计学意义(P＜0.01).术后1年,灌洗对照组动脉血氧分压明显高于术后接尘组,未灌洗对照组动脉血氧分压明显低于术前、术后接尘组和灌洗对照组,差异均有统计学意义(P＜0.05,P＜0.01);术后接尘组动脉血氧分压明显低于术前,灌洗对照组动脉血氧分压明显高于术前,差异有统计学意义(P＜0.01).3组对象术前、术后1个月和术后1年的二氧化碳分压的差异均无统计学意义(P＞0.05).结论行肺灌洗术后应避免继续从事接尘工作,以保证手术效果.
목적 탐토진폐관찰대상화Ⅰ기매공진폐환자행대용량폐관세술후재차종사접촉분진공작,대기림상증상급동맥혈기분석、폐공능적영향.방법 선택재준북광업집단직업병방치원행대용량폐관세수술적진폐관찰대상급Ⅰ기매공진폐환자,술후재접진자위술후접진조(86례),술후불재접진자위관세대조조(86례);이기동반조년령、접진사、접진충류대치상동적공우작위미관세대조조(86례).분별재술후접진조화관세조상규관세접수대용량폐관세술전、관세술후1개월급관세후1년시수방림상증상급동맥혈기분석、폐공능등지표.결과 술후1개월,술후접진조화관세대조조림상표현평분명현저우술전화미관세대조조,차이유통계학의의(P＜0.01).술후1년,술후접진조화관세대조조림상표현평분명현저우술전,미관세대조조림상표현평분명현고우술후접진조화관세대조조,관세대조조림상표현평분명현저우술후접진조,차이균유통계학의의(P＜0.01).술후1개월,술후접진조화관세대조조동맥혈양분압명현고우술전수평화미관세대조조,차이유통계학의의(P＜0.01).술후1년,관세대조조동맥혈양분압명현고우술후접진조,미관세대조조동맥혈양분압명현저우술전、술후접진조화관세대조조,차이균유통계학의의(P＜0.05,P＜0.01);술후접진조동맥혈양분압명현저우술전,관세대조조동맥혈양분압명현고우술전,차이유통계학의의(P＜0.01).3조대상술전、술후1개월화술후1년적이양화탄분압적차이균무통계학의의(P＞0.05).결론 행폐관세술후응피면계속종사접진공작,이보증수술효과.
Objective To investigate the effects of secondary dust exposure after whole-lung lavage (WLL) on the clinical symptoms,arterial blood gas parameters,and pulmonary function in subjects with pneumoconiosis and patients with stage Ⅰ coal workers' pneumoconiosis (CWP).Methods The subjects with pneumoconiosis and patients with stage Ⅰ CWP who underwent WLL in our hospital during the study period were selected.All patients were divided into postoperative dust exposure group (n=86) and lavage control group (n=86) according to whether they were exposed to dust after conventional operation.In addition,their workmates with similar age,history of dust exposure,and type of dust exposure were selected as non-lavage control group (n =86).Follow-up was performed before and at one month and one year after WLL to evaluate clinical symptoms,arterial blood gas parameters,and pulmonary function.Results One month after operation,the clinical scores of the postoperative dust-exposure group and lavage control group were significantly reduced compared with their preoperative scores and the clinical score of the non-lavage control group (P＜0.01).One year after operation,the clinical scores of the postoperative dust-exposure group and lavage control group were significantly reduced compared with their preoperative scores and the clinical score of the non-lavage control group (P＜0.01),and the lavage control group had a significantly lower clinical score than the postoperative dust exposure group (P＜0.01).One month after operation,the arterial partial pressure of oxygen (PaO2) of the postoperative dust-exposure group and lavage control group were significantly higher than their preoperative values and the arterial PaO2 of the non-lavage control group (P＜0.01).One year after operation,the lavage control group had significantly higher arterial PaO2 than the postoperative dust exposure group and the arterial PaO2 of the non-lavage control group was significantly lower than its preoperative value and the arterial PaO2 of the postoperative dust exposure group and lavage control group (P＜0.05 or P＜0.01); the postoperative dust exposure group showed a significant decrease in arterial PaO2 (P＜0.01),while the lavage control group showed a significant increase in arterial PaO2 (P＜0.01).The partial pressure of carbon dioxide showed no significant differencesbetween the three groups before and at one month and one year after operation (P＞0.05).Conclusion Dust exposure should be avoided after WLL to ensure the treatment outcome.