BRONCHOPULMONARY LAVAGE IN MAN
BRONCHOPULMONARY LAVAGE IN MAN
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DOI：
10.7326/0003-4819-63-5-819
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发表时间：
1965-01-01
影响因子：
39.2
通讯作者：
BALL, WC
中科院分区：
文献类型：
--
作者：
RAMIREZR, J;KIEFFER, RF;BALL, WC
本文提出了一种人的支气管肺灌洗方法，其基础是一侧肺完全灌入灌洗液，而另一侧肺用100%氧气进行换气。用一根支气管法分离每一肺的通气量。用100%氧气吸双肺10min，去除肺泡氮。然后选择要灌洗的肺进行部分脱气，并用含有肝素或1%乙酰半胱氨酸的等渗盐水填充到容量。灌洗是患者用一侧肺主动吸入和呼出液体，另一侧呼吸100%氧气。对6例患者进行了12次灌洗。对动脉血气的测量表明，整个手术过程中可以维持足够的氧合。对侧肺灌洗液溢出是最重要的并发症。在3例患者中，肺灌洗立即观察到良好的反应。2例患者，1例为肺泡蛋白沉积症，1例为慢性喘息性支气管炎，氧分压为6小时。灌洗后显著高于灌洗前。1例肺泡蛋白沉着症患者的X线片显示24小时广泛透明。在洗澡之后。支气管肺泡灌洗被认为是一种有效的清创方法。建议将该方法用于治疗肺泡蛋白沉积症和其他与肺清除过程功能障碍相关的肺部疾病。
A method for bronchopulmonary lavage in man is presented based on a complete filling of one lung with irrigating solutions while ventilating the other lung with 100% oxygen. A bronchospirometry tube was used to separate the ventilation of each lung. The alveolar nitrogen was removed by ventilating both lungs with 100% oxygen for 10 min. The lung selected for lavage was then partially degassed and filled to capacity with an isotonic saline solution containing heparin or 1% acetylcysteine. The lavage was produced by the patient actively inhaling and exhaling fluid with one lung while breathing 100% oxygen with the other. Twelve lavages have been performed on 6 patients. Measurements of the arterial blood gases showed that adequate oxygenation can be maintained throughout the procedure. Spilling of the irrigating solution in the contralateral lung was the most important complication. In 3 patients, an immediate favorable response to pulmonary lavage was observed. In 2 patients, one with alveolar proteinosis and the other with chronic asthmatic bronchitis, the oxygen tension 6 hr. after the lavage significantly exceeded that preceding it. The roentgenogram of 1 patient with alveolar proteinosis showed extensive clearing 24 hr. following the lavage. Bronchopulmonary lavage is proposed as an effective method of bron-chiolo-alveolar debridement. The experimental use of this method for the treatment of alveolar proteinosis and other pulmonary diseases associated with dysfunctions of the pulmonary clearing process is suggested.