42例右肺中叶综合征的纤支镜检查结果分析

[目的]探讨右肺中叶不张的病因及纤支镜的诊断价值。[方法]对42例经胸片或胸部CT诊断为右肺中叶不张的患者进行纤维支气管镜检查。[结果]发现病因中非特异性炎症占57.1%，肺癌占26.2%，结核占11.9%。纤支镜下的主要表现为充血水肿、狭窄、新生物、脓性分泌物及粘膜增厚等。纤支镜对肺癌、炎症、结核的诊断符合率分别为90.9%、87.5%、60％。炎症在青、中、老年组的分布无显著性差异，肺癌的分布以中老年组稍高，占30.3%，青年组占11.1%，但两组比较，差异无显著性（P＞0.05）。[结论]纤支镜检查是诊断右肺中叶不张病因的重要手段；右肺中叶不张的常见病因仍为炎症、肺癌和结核；40岁以上的男性患者，应及时行纤支镜排除肺癌的可能。

Fiberbronchoscopy for Right Middle Lobe Syndrome: A Report of 42 Cases

ive] To assess the diagnostic value of fiberbronchoscopy for right middle lobe syndrome (RMLS) and to explore the etiology of RMLS. [Methods] Fiberbronchoscopy was carried out in 42 casesof RMLS diagnosed by chest X-ray or CT. [Results] Patients with RMLS due to non-specific inflamma tion accounted for 57.1 % , lung cancer 26.2%and pulmonary tuberculosis 11.9%. Congestion, edema, stenosis, neoplasm, purulent secretion, and mucosa thickening were the main manifestations under fiber-bronchoscope. The diagnostic accordance rate of fiberbronchoscopy for lung cancer, non-specific inflam mation and pulmonary tuberculosis was 90.9% , 87.5% and 60% respectively. No significant differences of the incidences of non-specific inflammation and lung cancer were found in the teenage, the adult and the aged. [Conclusion] Fiberbronchoscopy is an important method of the diagnosis of RMLS. Lung can cer, non-specific inflammation and pulmonary tuberculosis are the common pathogenic factors of RMLS. Male cases over 40 should take fiberbronchoscopy to exclude the possibility of lung cancer.