The Application Of Impulse Oscillometry And Fractional Exhaled Nitric Oxide In Pneumoconiosis With Massive Whole-lung Lavage To Recent Effect Evaluation

Objective To evaluate the clinical effects of massive whole-lung lavage on impulseoscillometry, fractional exhaled nitric oxide, pulmonary function and clinical symptomsin patients with pneumoconiosis; To clarify the appliable value of impulse oscillometryand fractional exhaled nitric oxide in patients with pneumoconiosis.Methods A total of309patients diagnosed with pneumoconiosis were recruited.Impulse oscillometry and clinical symptoms were recored prior,1day and1week aftermassive whole-lung lavage, respectively. All patients completed pulmonary functionexamines before massive whole-lung lavage, and out of them,14patients were examinedwith impulse oscillometry and pulmonary function3months after massive whole-lunglavage. Fractional exhaled nitric oxide was recored from109patients at the time before,1day and1week after massive whole-lung lavage, respectively.Results1）FEV1.0, FEV1.0%, V50, V25and MMEF indexeswere found reducing withpneumoconiosis stages increasing in309patients（P＜0.01）. R5, R20indexes werefound growing with pneumoconiosis stages increasing（P＜0.05）, X5indexwas foundreducing（P＜0.01）, R5-R20and Fres indexes were found growing. R5, R20, R5-R20and Fres indexeswere found growing with pulmonary function damage increasing, andX5indexwas found reducing（P＜0.01）. The number of airway resistance abnormalexamined with impulse oscillometry was not significantly different in pulmonaryfunction examination. The number of small airway resistance abnormal examined withimpulse oscillometry was significantly more than in pulmonary function examination（P＜0.01）.2）The number of patients with dyspnea and chest tightness symptoms aftermassive whole-lung lavage was alleviated significantly（P＜0.01）, but the number ofpatients with symptoms of cough and sputum was increased significantly（P＜0.01）.R5, R20, R5-R20, X5and Fres were found significantly different in309patients withpneumoconiosis before and after the massive whole-lung lavage treatment. Comparedwith pre-operation, FEV1.0, FEV1.0%, V50, V25and MMEF indexes3months after themassive whole-lung lavage treatment in14patients with pneumoconiosis were foundincreasing, of which FEV1.0, FEV1.0%, V50and V25were found increasing significantly （P＜0.05）. Compared with pre-operation, R5, R20, R5-R20and Fres indexes3months after the massive whole-lung lavage treatment in14patients withpneumoconiosis were found reducing, and X5was found growing, of which R5and R20were found increasing reducing significantly （P＜0.05）.3） The schematicrepresentation showed the distribution of fractional exhaled nitric oxide levels in109patients, out of which81.65%measurements ranged from5to25ppb. The FeNO insilicosis was higher than in coal workers’ pneumoconiosis（P＜0.05）; the differentstage of pneumoconiosis did not show statistical significance（P＜0.05）; themeasurements of fractional exhaled nitric oxide did not show significant difference at thetime before、1day and1week after massive whole-lung lavage（P>0.05）.Conclusion1）Impulse oscillometry, which was better than pulmonary function test,could discover the abnormal detection rate of small airway resistance withpneumoconiosis and be used the early lung function evaluation after the treatment ofmassive whole-lung lavage.2）Impulse oscillometry changed after the treatment ofmassive whole-lung lavage. The treatment of massive whole-lung lavage could lead tobriefly aggravated damage after postoperative1day, but it could improve significantlyafter postoperative1week and reduce airway resistance.3）The measured value offractional exhaled nitric oxide test were no change after the treatment of massive whole-lung lavage.