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目的 探讨不同类型尘肺患者的肺区域性通气分布的特征及其对临床的应用价值。方法 对 132例不同类型尘肺患者进行了肺区域性阻抗通气图检测和常规肺功能试验 ,将结果与 10 0例健康人测定值比较。结果 铸工尘肺、矽肺和石棉肺 3种尘肺的肺区域性通气分布皆为两上肺区通气增加和两下肺区通气减少 ;而左、右两侧肺通气分布则以右侧肺通气增加为主 ,占 5 3.0 3%(70 / 132 ) ,与健康正常人肺阻抗通气图比较 ,差异有显著性 (P <0 .0 1)。三种尘肺之间比较 ,差异未见显著性 (P >0 .0 5 ) ,尘肺通气功能“正常”者与不同类型通气障碍者之间差异亦无显著性 (P >0 .0 5 )。 2例矽肺中 ,1例X线胸片显示其左侧上叶肺萎缩 ;另 1例并发左侧中央型肺癌。肺区域性阻抗通气图显示符合X线影像。结论 肺区域性阻抗通气图是非常规肺功能所能检测到的 ,可作为常规肺功能补充参数。对尘肺并发其他肺部区域性病变 ,临床似有可能用肺阻抗通气图替代核素显像通气法。
Objective To investigate the characteristics of regional pulmonary ventilation in patients with different types of pneumoconiosis and its clinical value. Methods 132 cases of different types of pneumoconiosis patients were tested by pulmonary impedance ventilation test and routine pulmonary function test, the results were compared with the measured values of 100 healthy subjects. Results The distribution of lung ventilation in three types of pneumoconiosis of castor pneumoconiosis, silicosis and asbestosis were increased in both upper lungs and lower in both lungs, while the left and right lungs increased with ventilation in the right lung as The main result was 53.03% (70/132), which was significantly different from that of healthy people in lung impedance ventilation (P <0.01). There was no significant difference between the three types of pneumoconiosis (P> 0.05). There was no significant difference between those with “normal” pneumoconiosis and different types of ventilatory disorders (P> 0.05). In 2 cases of silicosis, one case of X-ray showed atrophy of the left upper lobe and another case of central left-sided lung cancer. Lung regional impedance ventilation showed compliance with X-ray images. Conclusions Lung regional impedance ventilation pattern is detected by unconventional pulmonary function and can be used as a supplementary parameter of routine pulmonary function. Pneumoconiosis complicated with other regional lung disease, it seems clinically possible to use lung impedance ventilation instead of radionuclide imaging ventilation method.