【摘要】 目的总结透视下纤支镜肺活检病例,为肺部疾病的临床诊断提供前瞻性的依据。方法回顾性分析12年来共103例行透视下纤支镜肺活检病例的临床诊断和病理诊断资料。结果肺活检总体取材准确率为93.2%。取材准确的96例中,最终病理确诊75例,占78.1%,其中肺部感染25例,间质性肺疾病24例,肺部肿瘤21例。在96例中,影像学表现为肺部周围局部性病变有20例,病理确诊16例(80.0%)。其中以肺部肿瘤(8例)最为多见,其次为肺部感染(7例)。影像学表现为肺部弥漫性病变有76例,病理确诊59例(77.6%),以间质性肺疾病(24例)最为多见,其次为肺部肿瘤(18例)。75例病理诊断的病例中,病理诊断与出院诊断相符共67例,病理诊断准确率为89.3%。103例中术后出现咳血12例,气胸1例。结论对于肺部局部性病变,应注重肺部肿瘤的诊断;对于肺部弥漫性病变,则更注重间质性肺疾病的诊断。透视下纤支镜肺活检对于常规纤支镜不能明确病因的肺部疾病,是适应证广泛,准确率高,阳性率也较高的检查手段,可作为首选检查方式。更多还原

【Abstract】 【Objective】To investigate the cases of unknown pulmonary diseases using transbronchial lung biopsy (TBLB) under X-ray guidance. 【Methods】During 1996~2008, diagnostic trans-bronchial lung biopsy (TBLB) under X-ray guidance was performed in 109 consecutive patients in Tongji Hospital. Data collected from pathologic and clinic diagnosis was evaluated.【Results】Of these, 96(93.2%) patients, gained valid biopsy specimens. TBLB under X-ray guidance yielded pathologic diagnosis in 75(78.1%) of the patients. Among them, the most common diagnosis was pulmonary infection (25 cases), then interstitial lung disease (ILD) (24 cases) and malignant (21 cases). TBLB under X-ray guidance indicated localized pulmonary lesions in 20 patients, and diffuse pulmonary lesions in 76 patients. Localized lesions: TBLB yielded a pathologic diagnosis in 18 patients, of the 8 patients with malignancy, and 7 patients with pulmonary infection. Diffuse lesions: TBLB yielded a pathologic diagnosis in 78 patients, of the 24 patients with ILD, and 18 patients with malignancy. Of the 75 patients with pathologic diagnosis, 67 patients (89.3% ) consistented well the clinic diagnosis. Heamoptysis was occurred in 12 patients, and pneumatothorax was occurred in 1 patient after TBLB under X-ray guidance. 【Conclusions】TBLB under X-ray guidance is a safe and effective method, especially, in the diagnosis for the unknown diffuse lung disease.更多还原