经支气管肺活检对弥漫性及周围性肺病变的诊断价值  

Diagnostic Value of Transbronchial Lung Biopsy in Diffuse or Peripheral Lung Lesions

作　　者：陈文彬[1] 戢朝明[1] 李又环 徐大华 

机构地区：[1]华西医大内科学教研室

出　　处：《华西医科大学学报》1990年第3期330-333,共4页Journal of West China University of Medical Sciences

摘　　要：作者对102例弥漫性及周围性肺病变患者进行经支气管肺活检(TBLB)、支气管刷检及支气管肺泡灌洗检查,结果确诊率为74.5％。三项检查联合进行可提高阳性率。肺周围包块≥3cm者肺癌的可能性大,局限性浸润者肺结核的机会多,而弥漫性肺病变则可见于多种疾病,故仔细研究胸片可提供病因诊断的线索。TBLB为一种创伤性小,并发症低,阳性率高和安全度大的检查方法。The results of 102 cases of diffuse orperipheral lung lesions examined by trans-bronchial lung biopsy (TBLB), bronchialbrushing(BB), and bronchial alveolarlavage (BAL) via fiberoptic bronchoscope,were reported The positive diagnosticrate was 74.5％ (76 cases). In lung cancer,the positive rate by means of BB was77.1％, which was higher than that byTBLB (58. 1％). In pulmonary tuberculosis,the positive rate by TBLB was 76.9％,higher than that by BAL fluid for identi-fication of tubercle bacillus by culture(44.4％). If TBLB was combined withBB and BAL, the positive diagnostic ratewould be further elevated. The deta showed that if the size ofthe masses≥3cm in peripheral lung fieldon chest film, the possibility of lung can-cer was greater than that of those<3cm.Most cases of localized infiltration in thelungs were caused by tuberculosis. Butthe diffuse lesions of the lungs were oftencaused by bronchiolo--alveolar earcinoma,adenocarcinoma, diffuse interstitial fi-brosis of the lungs, silicosis, sarcoidosis,etc. By the careful study of the chestfilm and ascertainment of the exact lo-cations of the pulmonary lesions there,we can carry out the TBLB and obtain asatisfactory specimen without any X-raymonitoring. In the present group of patients whounderwent TBLB, one was complicatedby haemorrhage (>50ml) and two bypneumothorax, but all of them recoveredpromptly after proper mangement. Bystrick adherence to indication, adequatepreoperative preparations and very care-ful performance of the procedure, thecomplications of TBLB could be reducedto minimum. Therefore, we are of theopinion that TBLB is one of the leasttraumatic methods of examination withgreat safety yielding very high posi-tivity.

关 键 词：肺病变 支气管镜 肺活检 

分 类 号：R563.04[医药卫生—呼吸系统]