Objective To evaluate the efficacy and safety of whole lung lavage in the treatment of pulmonary alveolar proteinosis ( PAP) .Methods Twelve patients who were diagnosed as PAP from September 2008 to October 2011 in Hunan Occupational Disease Hospital were recruited in the study. The changes of dyspnea symptom, lung-function, arterial blood gas, and chest image were compared before and after whole lung lavage treatment. Meanwhile, the safety of lung lavage was evaluated. Results All patients were relieved from dyspnea. The lung function, hypoxia, hyperventilation, and chest image were all obviously improved. The vital signs in the process of lung lavage were stable without serious complications. Conclusion Whole lung lavage is an effective and safe treatment for PAP.
ObjectiveTo improve the diagnosis and treatment of pulmonary alveolar proteinosis (PAP). MethodsThe clinical data of 34 PAP cases diagnosed between May 2008 and June 2015 in Hunan Prevention and Treatment Center for Occupational Diseases were retrospectively analyzed. ResultsThere were 34(52.9%)patients with a history of dust exposure. Cough and progressive dyspnea were common clinical symptoms. The incidence rate of hypoxemia and lung function damage was 87.9% and 90.9%,respectively. High resolution CT clearly demonstrated the characteristic map-like changing and paving-stone sign. Arterial blood oxygen partial pressure increased from (62.5±12.9)mm Hg to (73.0±12.2)mm Hg,and DLCO%pred increased from (50.1±14.9)% to (64.6±14.4)% after large-volume whole lung lavage. The recurrence rate was 38.2%. ConclusionThe etiology of PAP is unknown,dust exposure may be associated with secondary PAP. The effect of whole lung lavage is remarkable but the recurrence rate is high. It is needed to study further on etiological treatment of PAP.
目的:肺泡蛋白沉積癥(pulmonary alveolar proteinosis,PAP)是一種少見的肺部疾病,由于臨床醫生認識不足,容易誤診,而PAP通過灌洗治療常常可獲得較好的預后。本文通過分析PAP病例,總結PAP患者的臨床特點、影像學表現和治療方法,以提高該病的診療水平。方法:回顧性分析2003年2月～2008年5月四川大學華西醫院呼吸科經病理確診的15例PAP患者臨床資料,并觀察了全肺灌洗治療PAP的效果。結果:PAP患者常見臨床癥狀為咳嗽和進行性呼吸困難,體征正常或無特異性。胸部CT可表現為“地圖樣”、“鋪路石樣”或間質纖維化改變。全肺灌洗治療的14例患者臨床癥狀明顯緩解。結論:肺泡蛋白沉積癥雖然少見,但只要提高認識,診斷并不困難。支氣管肺泡灌洗和(或)肺活檢是確診PAP的重要方法,全肺灌洗是治療PAP的主要方法。