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目的为扩大大容量全肺灌洗（ＭＷＬＬ）治疗尘肺的适应征，对疑难复杂ＭＷＬＬ的主要问题进行探讨。方法采用风险指数积分法进行适应征选择，术中合理应用纯氧正压通气，适当延长麻醉维持时间，加强术后监测。结果疑难组９３例１３４例次ＭＷＬＬ，普通组６９例７６例次ＭＷＬＬ，均获满意疗效。双肺同期灌洗率前者（５５．９％，５２／９３）明显低于后者（８４．８％，６２／６４），而术中不良反应前者（２８．４％，３８／１３４）明显高于后者（１１．５％，８／６９）。结论熟练的ＭＷＬＬ操作技术，尤其是纯氧正压通气，是降低疑难复杂ＭＷＬＬ不良反应的有效措施。
Objective To explore the indications for the treatment of pneumoconiosis by large-volume whole lung lavage (MWLL). Methods Adopting the risk index integral method to choose the appropriate indications, the positive oxygen positive pressure ventilation was applied during the operation, the anesthesia maintenance time was appropriately prolonged, and postoperative monitoring was strengthened. Results The difficult group had 93 cases of MWLL in 93 cases and 69 cases of MWLL in common group, all of which achieved satisfactory results. The former (55.9%, 52/93) was significantly lower than the latter (84.8%, 62/64) in the same period of double-lung lavage, while the former had significant intraoperative adverse reactions (28.4%, 38/134) Higher than the latter (11.5%, 8/69). Conclusion Skilled MWLL technique, especially pure oxygen positive pressure ventilation, is an effective measure to reduce the adverse reactions of difficult complex MWLL.