Zhou Z Q, Guo W L, Chen Y, Zhong C H, Li S Y
State Key Laboratory of Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Disease, Guangzhou 510120, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2017 Jul 12;40(7):499-503. doi: 10.3760/cma.j.issn.1001-0939.2017.07.004.
To evaluate the safety of the procedures of whole lung lavage(WLL) for pulmonary alveolar proteinosis(PAP) in perioperative period. In this retrospective study, we collected clinical data from 78 WLL procedures of PAP patients from January 2006 to June 2016 in Guangzhou Institute of Respiratory Disease. The causes of perioperative complications were analyzed. Eighteen (23.07%) of the 78 procedures developed complications, including pleural effusion(=4), pneumonia(=4), cardiac failure(=2), cardiac arrhythmia (=2), pneumothorax(=2), atelectasis(=1), lung edema(=1), laryngeal edema(=1), pleural effusion and pneumonia(=1). All complications were mild and easy to treat. Seventy-four procedures had successful extubation, but 4 procedures developed a prolonged time of extubation. Age, DSS, PaCO(2,)FEV(1,)lavage volume, lavage times and underlying diseases were not predictors for any complications(each >0.05). High fluid recovering rate had a protective effect against the occurring of complications (=7.672, <0.01, <0.05). Whole lung lavage was a safe procedure in the treatment of PAP. Complications could recovery after proper therapy. The perioperative complications showed a correlation with low fluid recover rate. Operation under guideline was the key to avoid complications.
评估肺泡蛋白沉积症(PAP)患者全肺灌洗(WLL)围手术期操作的安全性。在这项回顾性研究中,我们收集了2006年1月至2016年6月期间广州呼吸疾病研究所78例PAP患者WLL操作的临床资料。分析围手术期并发症的原因。78例操作中有18例(23.07%)出现并发症,包括胸腔积液(4例)、肺炎(4例)、心力衰竭(2例)、心律失常(2例)、气胸(2例)、肺不张(1例)、肺水肿(1例)、喉水肿(1例)、胸腔积液合并肺炎(1例)。所有并发症均较轻且易于治疗。74例操作拔管成功,但4例操作拔管时间延长。年龄、疾病严重程度评分(DSS)、动脉血二氧化碳分压(PaCO₂)、第一秒用力呼气容积(FEV₁)、灌洗量、灌洗次数及基础疾病均不是任何并发症的预测因素(均P>0.05)。高液体回收率对并发症的发生有保护作用(P=7.672,P<0.01,P<0.05)。全肺灌洗治疗PAP是一种安全的操作。适当治疗后并发症可恢复。围手术期并发症与低液体回收率相关。遵循指南操作是避免并发症的关键。