25例肺泡蛋白沉积症临床特征及全肺灌洗疗效分析
发布时间：2018-10-16 10:14
【摘要】：目的通过对肺泡蛋白沉积症病例的分析,总结该病的临床特点及评价大容量全肺灌洗治疗肺泡蛋白沉积症的疗效及安全性,以提高对该疾病的认识。 方法回顾性分析2005年5月-2012年12月在广西医科大学第一附属医院住院的25例经病理确诊肺泡蛋白沉积症患者临床资料,观察大容量全肺灌洗术中安全性,对比大容量全肺灌洗前后患者的临床症状、动脉血气、肺功能及胸部CT的改变。 结果本组患者主要临床症状为进行性活动后气促。胸部CT示两肺弥漫性斑片状、磨玻璃样及网格状阴影。确诊依赖肺组织活检和/或肺泡灌洗液过碘酸雪夫染色阳性。25例患者均在住院期间行全肺灌洗术治疗,治疗后24例患者临床症状、血气分析、肺功能及胸片或胸部CT均有明显改善,1例发生气胸。 结论肺泡蛋白沉积症以渐进性活动后气促为主要临床表现,以“地图征”“铺路石征”为胸部CT特征性改变,确诊主要依靠病理学检查。迄今为止治疗首选大容量全肺灌洗,全肺灌洗治疗肺泡蛋白沉积症安全、有效。
[Abstract]:Objective to summarize the clinical features of pulmonary alveolar proteinosis and evaluate the efficacy and safety of large volume whole lung lavage in the treatment of alveolar proteinosis, so as to improve the understanding of the disease. Methods the clinical data of 25 pathologically diagnosed pulmonary alveolar proteinosis patients in the first affiliated Hospital of Guangxi Medical University from May 2005 to December 2012 were retrospectively analyzed. The changes of clinical symptoms, arterial blood gas, pulmonary function and chest CT were compared before and after large volume whole lung lavage. Results the main clinical symptoms of the patients were dyspnea after progressive exercise. Chest CT showed diffuse patchy, glass-like and reticular shadows of both lungs. The diagnosis depended on lung biopsy and / or alveolar lavage fluid periodate Sheff staining positive. Twenty-five patients were treated with whole lung lavage while in hospital. After treatment, 24 patients had clinical symptoms and blood gas analysis. Pulmonary function and chest radiographs or chest CT were significantly improved. Pneumothorax occurred in 1 case. Conclusion the main clinical manifestation of pulmonary alveolar proteinosis is progressive dyspnea, and the characteristic changes of chest CT are "map sign" and "paving stone sign". The diagnosis of pulmonary alveolar proteinosis mainly depends on pathological examination. Up to now, the first choice for the treatment of large volume whole lung lavage, whole lung lavage for alveolar proteinosis is safe and effective.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R563
本文编号：2274034
[Abstract]:Objective to summarize the clinical features of pulmonary alveolar proteinosis and evaluate the efficacy and safety of large volume whole lung lavage in the treatment of alveolar proteinosis, so as to improve the understanding of the disease. Methods the clinical data of 25 pathologically diagnosed pulmonary alveolar proteinosis patients in the first affiliated Hospital of Guangxi Medical University from May 2005 to December 2012 were retrospectively analyzed. The changes of clinical symptoms, arterial blood gas, pulmonary function and chest CT were compared before and after large volume whole lung lavage. Results the main clinical symptoms of the patients were dyspnea after progressive exercise. Chest CT showed diffuse patchy, glass-like and reticular shadows of both lungs. The diagnosis depended on lung biopsy and / or alveolar lavage fluid periodate Sheff staining positive. Twenty-five patients were treated with whole lung lavage while in hospital. After treatment, 24 patients had clinical symptoms and blood gas analysis. Pulmonary function and chest radiographs or chest CT were significantly improved. Pneumothorax occurred in 1 case. Conclusion the main clinical manifestation of pulmonary alveolar proteinosis is progressive dyspnea, and the characteristic changes of chest CT are "map sign" and "paving stone sign". The diagnosis of pulmonary alveolar proteinosis mainly depends on pathological examination. Up to now, the first choice for the treatment of large volume whole lung lavage, whole lung lavage for alveolar proteinosis is safe and effective.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R563
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