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目的 :通过观察SARS患者临床治愈后肺功能的变化 ,了解SARS患者是否遗留有肺功能的长期损害。方法 :对 82例SARS患者 (实验组 )出院 3个月后进行临床随访及肺功能检测 ,同时测定 2 8例健康人的肺功能作为对照组 ,对结果进行分析。结果 :肺功能检测发现一氧化碳弥散量 (DLCO % )实验组均值为 78.4 %± 17.4 % ,对照组为 93.8%± 13.6 % (P <0 .0 1)。实验组中有 4 6例 (5 6 .1% )存在弥散功能障碍 (DLCO % <80 % ) ,37例 (45 .1% )有小气道功能障碍 ,2 8例 (34.1% )残总比增加 (RV/TLC >35 % ) ,9例 (10 .9% )有限制性通气功能障碍。按照患者住院期间病情最重时胸片的改变 (以肺部斑片状影占据肺叶的范围为标准 ) ,将患者分为轻、中、重 3组 ,病情轻重程度与出院后 3个月肺弥散功能损害呈正相关。重症患者使用机械通气治疗组与未使用机械通气治疗组肺功能损害差异不明显。结论 :SARS患者治愈出院 3个月后 ,部分患者遗留有肺功能损害 ,主要以弥散功能障碍为主 ,其次为小气道阻塞和残气增加 ,少数有限制性通气功能障碍。
OBJECTIVE: To investigate the long-term impairment of pulmonary function in patients with SARS by observing the changes of lung function after clinical cure in SARS patients. Methods: 82 cases of SARS patients (experimental group) were discharged from hospital for 3 months after the clinical follow-up and pulmonary function tests, and determination of 28 healthy people of lung function as a control group, the results were analyzed. Results: The lung function test showed that the average value of diffusing volume of carbon monoxide (DLCO%) was 78.4% ± 17.4% in the experimental group and 93.8% ± 13.6% in the control group (P <0.01). In the experimental group 46 cases (56.1%) had diffuse dysfunction (DLCO% <80%), 37 cases (45.1%) had small airway dysfunction, and 28 cases (34.1% (RV / TLC> 35%), and 9 (10.9%) had restrictive ventilatory dysfunction. Patients were divided into mild, moderate and severe groups according to the change of chest radiograph (the range of pulmonary lobes occupying lung lobes) during the hospitalization, Diffusion dysfunction was positively correlated. There was no significant difference in lung function impairment between severe patients using mechanical ventilation and those without mechanical ventilation. CONCLUSIONS: After 3 months of hospitalized patients with SARS, some patients have lung function impairment left behind, mainly diffuse dysfunction, followed by small airway obstruction and residual air loss and a few with restrictive ventilatory dysfunction.