Selecky P A, Wasserman K, Benfield J R, Lippmann M
Ann Thorac Surg. 1977 Nov;24(5):451-61. doi: 10.1016/s0003-4975(10)63440-6.
We have utilized whole-lung lavage in the successful treatment of 18 patients with pulmonary alveolar proteinosis. Our ten-year experience includes serial evaluations of patients with disabling lung dysfunction who had a total of 49 whole-lung lavages under general anesthesia. Clinical and physiological responses were documented both before and after each lavage. There were no complications or deaths. All patients were radiographically, physiologically, and symptomatically improved within hours after the procedures. Five patients required from two to four repeat lavages one to three years later. The treatment of this disorder has included a wide variety of techniques. We attribute our results to the use of a lung lavage technique that includes: (1) unilateral whole-lung lavages at two to three day intervals; (2) isotonic saline as the lavage solution; (3) use of a mechanical chest percussor during lavage; and (4) measuring the total thoracic compliance of each side in the immediate postlavage period as a guide for extubation. We conclude that whole-lung lavage is a safe, highly effective, repetitively applicable treatment for pulmonary alveolar proteinosis.
我们采用全肺灌洗术成功治疗了18例肺泡蛋白沉积症患者。我们十年的经验包括对患有严重肺功能障碍的患者进行系列评估，这些患者在全身麻醉下共接受了49次全肺灌洗。每次灌洗前后都记录了临床和生理反应。没有出现并发症或死亡情况。所有患者在操作后数小时内，影像学、生理指标及症状均有改善。5例患者在1至3年后需要进行2至4次重复灌洗。该疾病的治疗方法多种多样。我们将我们的结果归因于所采用的肺灌洗技术，该技术包括：（1）每隔两到三天进行一次单侧全肺灌洗；（2）使用等渗盐水作为灌洗溶液；（3）灌洗期间使用机械胸部叩击器；（4）在灌洗后立即测量每侧胸廓的总顺应性，以此作为拔管的指导。我们得出结论，全肺灌洗术是一种安全、高效、可重复应用的肺泡蛋白沉积症治疗方法。
