超细支气管镜在诊断肺外周侵袭性真菌感染中的应用价值  

Application value of ultra-thin bronchoscopy in the diagnosis of peripheral pulmonary invasive fungal infection

作　　者：刘星 高蔚 王丽芳 施斌 LIU Xing;GAO Wei;WANG Lifang;SHI Bin(Department of Respiratory Medicine,Nanjing Drum Tower Hospital Group Suqian Hospital,the Affiliated Suqian Hospital of Xuzhou Medical University,Jiangsu Province,Suqian 223800,China)

机构地区：[1]南京鼓楼医院集团宿迁医院/徐州医科大学附属宿迁医院呼吸科,江苏宿迁223800

出　　处：《中国当代医药》2023年第31期37-40,45,共5页China Modern Medicine

基　　金：江苏省宿迁市指导性科技计划项目(Z2018190)。

摘　　要：目的评价超细支气管镜在诊断肺外周侵袭性真菌感染中的应用价值。方法选取2018年8月至2022年7月徐州医科大学附属宿迁医院收治的109例疑似肺外周侵袭性真菌感染患者作为研究对象,按照随机数字表法分为常规支气管镜组(54例)与超细支气管镜组(55例),所有患者经支气管镜行支气管肺泡灌洗(BAL)、刷检及活检。比较两组检查方法的诊断价值及安全性。结果两组的性别、年龄、吸烟史、饮酒史、合并症、实验室检查、病灶位置及诊断率比较,差异无统计学意义(P>0.05)。最终诊断为肺外周侵袭性真菌感染共82例,其中常规支气管镜组39例(72.22%),超细支气管镜组43例(78.18%)。两组的BAL、刷检、活检及检出病原体比较,差异无统计学意义(P>0.05)。经超细支气管镜检查与常规支气管镜检查诊断肺外周侵袭性真菌感染的特异度、敏感度及准确度比较,差异无统计学意义(P>0.05)。超细支气管镜组的不良反应总发生率(18.18%)低于常规支气管镜组(42.59%),差异有统计学意义(P<0.05)。结论超细支气管镜是一种有效的诊断肺外周侵袭性真菌感染方法,且安全性高。Objective To evaluate the application value of ultra-thin bronchoscopy in the diagnosis of peripheral pulmonary invasive fungal infection.Methods A total of 109 patients with suspected peripheral pulmonary invasive fungal infection admitted to the Affiliated Suqian Hospital of Xuzhou Medical University from August 2018 to July 2022 were selected as the research objects.According to the random number table method,they were divided into conventional bronchoscopy group(54 cases)and ultra-thin bronchoscopy group(55 cases).All patients underwent bronchoalveolar lavage(BAL),brushing and biopsy through bronchoscopy.The diagnostic value and safety of the two groups were compared.Results There were no sig-nificant differences in gender,age,smoking history,drinking history,complications,laboratory examination,lesion location and diagnostic rate between the two groups(P>0.05).A total of 82 cases were finally diagnosed with peripheral pulmonary invasive fungal infection,including 39 cases(72.22%)in the conventional bronchoscopy group and 43 cases(78.18%)in the ultra-thin bronchoscopy group.There were no significant differences in BAL,brushing,biopsy and pathogen detection be-tween the two groups(P>0.05).There were no significant differences in specificity,sensitivity and accuracy between ul-tra-thin bronchoscopy and conventional bronchoscopy in the diagnosis of peripheral pulmonary invasive fungal infection(P>0.05).The overall incidence of adverse reactions in the ultra-thin bronchoscopy group(18.18%)was lower than that in the conventional bronchoscopy group(42.59%),and the difference was statistically significant(P<0.05).Conclusion Ul-tra-thin bronchoscopy is an effective method for the diag-nosis of peripheral pulmonary invasive fungal infection with high safety.

关 键 词：超细支气管镜 侵袭性真菌感染 应用价值 不良反应 

分 类 号：R563[医药卫生—呼吸系统]