肺活检术在急性呼吸窘迫综合征中的应用及展望  

Application and prospect of lung biopsy in acute respiratory distress syndrome

作　　者：何倩[1,2] 王业 HE Qian;WANG Ye(Department of Pulmonary and Critical Care Medicine,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China;Department of Geriatrics,Chengdu Dekang Hospital,Chengdu,Sichuan 610091,P.R.China)

机构地区：[1]四川大学华西医院呼吸与危重症医学科,成都610041 [2]成都市德康医院老年科,成都610091

出　　处：《华西医学》2023年第1期12-17,共6页West China Medical Journal

基　　金：四川大学华西医院学科卓越发展1·3·5工程临床研究孵化项目(2022HXFH005)。

摘　　要：急性呼吸窘迫综合征是一种由多种原因引起的、以顽固性低氧血症为显著特征的临床综合征,其病因复杂多样,病死率高。肺活检技术可给予此类患者精确的组织病理学诊断以指导治疗并改善预后。目前肺活检技术包括手术肺活检、经支气管冷冻肺活检、经支气管镜肺活检、经皮穿刺肺活检等。手术肺活检诊断率高,但创伤大,实施难度高;经支气管冷冻肺活检诊断率相对高,并发症可接受;经支气管镜肺活检创伤小但诊断率偏低;经皮穿刺肺活检诊断率较高,并发症相对少。对于需行肺活检的急性呼吸窘迫综合征患者,根据不同术式的有效性、安全性以及适用情况进行选择十分重要。Acute respiratory distress syndrome is a clinical syndrome caused by many reasons,which is characterized by intractable hypoxemia.Its etiology is complex and its mortality is high.Lung biopsy techniques can give accurate histopathological diagnosis to such patients to guide treatment and improve prognosis.At present,lung biopsy techniques include surgical lung biopsy,transbronchial lung cryobiopsy,transbronchial lung biopsy and percutaneous lung biopsy.The diagnostic rate of surgical lung biopsy is high,but it is traumatic and difficult to implement.The diagnostic rate of transbronchial cryobiopsy is relatively high,and the complications are acceptable.Transbronchial lung biopsy is minimally invasive but the diagnostic rate is low.The diagnostic rate of percutaneous lung biopsy is relatively high,and the complications are relatively few.For patients with acute respiratory distress syndrome who need lung biopsy,it is very important to choose different surgical procedures according to their effectiveness,safety and applicability.

关 键 词：急性呼吸窘迫综合征 手术肺活检 经支气管冷冻肺活检 经支气管镜肺活检 经皮穿刺肺活检 

分 类 号：R563.8[医药卫生—呼吸系统]