2361例不明原因咯血患者支气管镜下特点与临床

目的了解不明原因咯血患者支气管镜下特点,探讨支气管镜检查对咯血病因诊断的价值。方法结合临床资料对2361例不明原因咯血患者支气管镜镜下表现和病因进行分析。结果2361例不明原因咯血患者镜下表现为管腔内菜花样、乳头状、球形或结节样新生物时93.5%为支气管肺癌,炎症也占有一定比例(4.2%);镜下表现为支气管黏膜肥厚、凹凸不平者,支气管肺癌占95.6%,4.2%为支气管结核所致;镜下见黏膜充血水肿,伴或不伴脓性或黏性分泌物是支气管炎性病变的突出表现,支气管炎88.7%、支气管扩张5.1%;而瘢痕狭窄仅见于结核患者。结论不明原因咯血患者支气管镜下表现主要为支气管黏膜充血水肿,其次是管腔内新生物形成,黏膜肥厚、凹凸不平,主要病因分别是支气管肺癌、支气管炎性病变和结核。

Characteristics of 2361 hemoptysic patients observed by fiberbronchoscooy

Objective] To observe know the characteristics of 2361 hemoptysic patients under fiberbronchosco-py,and to discuss the value of fiberbronchoscopy in treating hemoptysic patients.Methods] Retrospective analysis of the clinical data and the bronchoscopy results of 2361 patients who had been suffered from hemoptysis was done.Results] Among the 2361 hemoptysic patients,whose bronchoscopic findings showed neoplastic masses,pulmonary carcinoma patients were dominating,accounted for 93.5%,while the remaining 4.2% had bronchial inflammation.Among patients with bronchial stenosis and varicose of bronchial mucosa,95.6% were caused by pulmonary carcinoma,and 4.2% by bronchial tuberculosis.Among the patients who had edema of bronchial mucosa accompanied by pyoid secretion or not under bronchoscopy,88.7% were diagnosed as bronchial inflammation,while 5.1% of bronchiectasis.The cicatrisation was only found in bronchial tuberculosis patients.Conclusion] The primary characteristics of hemoptysic patients are edema of bronchial mucosa,followed by neoplastic masses,bronchial stenosis and varicose of bronchial mucosa.And the major pathogeny are pulmonary carcinoma,bronchial phlogistic pathological changes and bronchial tuberculosis.