OBJECTIVE： To investigate the effects of aerosol inhalation of budesonide combined with Compound ipratropium bromide on therapeutic efficacy and safety of patients with pneumoconiosis during perioperative period of massive whole-lung lavage （WLL）. METHODS： One hundred and fifty male patients with pneumoconiosis receiving WLL under general anesthesia selected from our hospital during Dec. 2014-May 2016 were divided into treatment group and control group in accordance with random number table， with 75 cases in each group. Both groups received WLL under general anesthesia as well as pure-oxygen manual positive pressure ventilation alternating with negative pressure drainage keeping interval and respiratory rate of ventilator synchronization. Treatment group was given Budesonide suspension 2 mL， bid+ Compound ipratropium bromide solution 2.5 mL， tid， by aerosol inhalation from 3 d before surgery to 3 d after surgery. The levels of arterial blood gas indexes （pH， PaO2， PaCO2， BE） at different lavage stages， lung function indexes （FVC， MVV， FEV1/FVC）， blood gas indexes and clinical symptom score 3 d before surgery and 7 d after surgery were observed in 2 groups， and the occurrence of ADR was recorded. RESULTS： After two-lung ventilation for 20 min following unilateral/bilateral lung lavage， PaO2 of 2 groups were all increased significantly compared to before surgery， with statistical significance （P＜0.05）； but there was no statistical significance between 2 groups （P＞0.05）. three days after surgery， FVC， MVV， FEV1/FVC and PaO2 of 2 groups were all increased significantly， PaCO2 and clinical symptom score were all decreased significantly. FVC， FEV1/FVC， PaO2 and clinical symptom score of treatment group were significantly better than those of control group， with statistical significance （P＜0.05）. The incidence of airway spasm， hypoxemia and airway pressure increasing in treatment group were significantly lower than in control group， with statistical significance （P＜0.05）. CONCLUSIONS： During perioperative period of WLL， the aerosol inhalation of budesonide combined with Compound ipratropium bromide for patients with pneumoconiosis can improve clinical efficacy of WLL and reduce the occurrence of ADR during surgery.