【摘要】：目的通過對肺泡蛋白沉積癥病例的分析,總結(jié)該病的臨床特點及評價大容量全肺灌洗治療肺泡蛋白沉積癥的療效及安全性,以提高對該疾病的認識。 方法回顧性分析2005年5月-2012年12月在廣西醫(yī)科大學(xué)第一附屬醫(yī)院住院的25例經(jīng)病理確診肺泡蛋白沉積癥患者臨床資料,觀察大容量全肺灌洗術(shù)中安全性,對比大容量全肺灌洗前后患者的臨床癥狀、動脈血氣、肺功能及胸部CT的改變。 結(jié)果本組患者主要臨床癥狀為進行性活動后氣促。胸部CT示兩肺彌漫性斑片狀、磨玻璃樣及網(wǎng)格狀陰影。確診依賴肺組織活檢和/或肺泡灌洗液過碘酸雪夫染色陽性。25例患者均在住院期間行全肺灌洗術(shù)治療,治療后24例患者臨床癥狀、血氣分析、肺功能及胸片或胸部CT均有明顯改善,1例發(fā)生氣胸。 結(jié)論肺泡蛋白沉積癥以漸進性活動后氣促為主要臨床表現(xiàn),以“地圖征”“鋪路石征”為胸部CT特征性改變,確診主要依靠病理學(xué)檢查。迄今為止治療首選大容量全肺灌洗,全肺灌洗治療肺泡蛋白沉積癥安全、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.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R563

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本文編號：2274034