【作者】 聂华萍； 胡成平； 杨红忠； 杨华平； 瞿素洁；

【Author】 Nie Hua-ping Hu Cheng-ping Yang Hong-zhong Yang Hua-ping Qu Su-jie (Xiangya 1st Hospital,Central South University,Changsha,Hunan 410008,P.R.China)

【机构】 中南大学湘雅医院呼吸科；

【摘要】 目的探讨肺不张支气管镜下特点与临床各因素的相关性。方法回顾性分析 1359例肺不张患者的临床资料和支气管镜下表现。结果 (1)1359例患者经支气管镜等检查明确病因1294例,支气管镜总诊断率为95．2%,其中肿瘤确诊率为85．9%；(2)男性、中老年或重度吸烟肺不张者中最多见的镜下表现是腔内菜花样肿物,女性、青年或不吸烟肺不张者则以管腔瘢痕狭窄闭塞为主；(3)腔内菜花样肿物多见于双上叶,左上叶明显多于右上叶；脓性分泌物者以右中叶居多；(4)镜下表现为菜花样或息肉样肿物者多提示为肿瘤(74．5%), 其中又以鳞癌居多(55．4%)；而表现为瘢痕狭窄或闭塞者多为结核(80．6%),脓性/稀薄或血性分泌物者则多为炎症表现(92．9%)。结论支气管镜是一种明确肺不张病因的重要手段。不同年龄、性别、吸烟量和病理类型肺不张者支气管镜下表现各异。更多还原

【Abstract】 【Objective】To investigate the association between bronchoscopic feature and some clinical factors in patients with pulmonary atelectasis.【Methods】Review retrospectively the clinical data and bronchoscopic manifestation in 1359 patients with atelectasis.【Result】(1)The cause for atelectasis was identified in 1294 of 1359 patients by bronchoscope and other methods.The total di- agnostic rate of bronchoscopy was 95.2%,among which the rate of tumor was 85.9%;(2)The most common bronchoscopic manifestation in male,middle-aged and elderly patients or heavy smokers was the cauliflower-like mass in bronchial lumen,while the manifestation was the cicatricial con- struction and obturation in female,youth or no-smokers;(3)The cauliflower mass in lumen was prone to grow at bilateral lung upper lobes and the purulent secretion was seen frequently at the right mid- dle lobe;(4)The manifestation of cauliflower-like or polypoid-like mass in lumen was usually indica- tive to tumor(74.5%)of which squamous carcinoma(55.4%)took the first place.The bronchial cica- tricial construction or obturation was always shown in patients with tuberculosis(80.6%),and the purulence or dilute or hematodes secretion mostly in inflammation(92.9%).【Conclusion】Bron- choscopy plays an important role in etiological diagnosis of pulmonary atelectasis;Different age, sex,amount of smoking and pathologic categories for atelectasis showed a great diversity of mani- festation under bronchoscope.更多还原