106例上叶肺不张纤维支气管镜检查  

FIBEROPTIC BRONCHOSCOPIC ANALYSIS OF 106 CASES WITH ATELECTASIS IN UPPER LOBES OF LUNG

作　　者：张家春[1] 袁玉如[1] 朱辉[1] 

机构地区：[1]四川大学华西医院呼吸内科,成都610041

出　　处：《中国内镜杂志》2002年第10期11-13,共3页China Journal of Endoscopy

摘　　要：目的 :了解上叶肺不张常见病因及纤维支气镜检查对明确诊断的重要性。方法 :用纤维支气管镜对 10 6例上叶肺不张的病人行气管腔内检查 ,结合活检、刷检、抗酸染色等。结果 :10 1例纤支镜检查明确病因学诊断 ,确诊率 10 1/ 10 6 (95 .3% )。右上叶肺不张发生率 (6 3% ) ,总体高于左上叶 (37% )。中老年组上叶肺不张发生率 (76 % )高于青年组 (2 4 % )。中老年上叶肺不张以恶性肿瘤 (6 7% )为主 ,炎症 (15 % )次之 ,结核 (8.6 % )较少见 ;青年人以炎症 (4 8% )为主 ,结核 (16 % )、肿瘤 (12 % )次之。肺癌所致上叶肺不张以中老年男性居多4 7/ 5 4 (87% ) ,以鳞癌居首位 4 2 / 5 4 (77% ) ,。结论 :纤支镜可对上叶肺不张作出病因学诊断 ,确诊率高。中老年上叶肺不张多数由肺癌所致 ,鳞癌居首位 ,青年人上叶肺不张以炎症为主。Objective:To investigate the etiologic causes of atelectasis in upper lobes of lung by fiberoptic bronchoscopy. Methods:106 cases with atelectasis in upper lobes of lung were examined by fiberoptic bronchoscopy, in addition to biopsy, brush biopsy, and Ziehl-Neelsen staining. Results:The etiologic causes of atelectasis in upper lobes of lung were determined in 101 cases of 106 cases by above methods, the diagnostic rate reached 95.3%. The incidence of atelectasis in right upper lobes of lung was higher (63%) than that in left upper lobes of lung (37%),and higher (76%) in older (≥40yr) patients than that in younger ones (24%). The malignant tumors were the major cause of the atelectasis (67%) in older patients, squamous cell carcinoma was the main diagnosis (77%), inflammation (15%) and tuberculosis (8.6%) were the minor causes for these old patients. While in younger subjects, the major cause was inflammation (48%), and tumor (12%), tuberculosis (16%) were the minors. Conclusions:Fiberoptic bronchoscopy has a high diagnostic rate for etiologic causes of atelectasis in upper lobes of lung. the major cause of the atelectasis in older patients was lung carcinoma, especially the squamous cell carcinoma. In young persons, however, the inflammation was the main cause of atelectasis. Fiberoptic bronchoscopy can also do some treatment in addition diagnosis.

关 键 词：肺上叶 肺不张 纤维支气管镜检查 诊断 病因学 

分 类 号：R768.1[医药卫生—耳鼻咽喉科] R563.4[医药卫生—临床医学]