536例纤维支气管镜检查诊断价值及安全性分析

目的评价纤维支气管镜检查的诊断价值及安全性.方法回顾性分析我院2001年4月至2002年10月间536例接受纤维支气管镜检查患者临床资料、纤支镜镜下表现,按其年龄分为老年组(年龄≥60岁)和非老年组(年龄＜60岁).结果老年组101例中诊断为肺癌30例(29.7%),支气管内膜结核2例(1.98%).非老年组435例中诊断为肺癌15例(3.45%),支气管内膜结核17例(3.91%).老年组的肺癌百分比与非老年组比较差异具有显著性(P＜0.01).30例老年组肺癌患者中以鳞癌最多,占53.33%,其次是腺癌(26.66%).15例非老年组肺癌患者中以未分化癌为主,有6例,占40%.非老年组肺癌中未分化癌的百分比显著高于老年组(P＜0.05).肺癌镜下表现为管内增殖型者常见为鳞癌(62.07%)和未分化癌(20.70%),而管壁浸润型中腺癌的比例最大(50%).纤维支气管镜检查时无1例发生严重并发症或死亡.结论纤维支气管镜检查是诊断肺癌、肺结核等肺部疾病的重要手段,肺癌在纤支镜下所见征象与病理类型相关.纤维支气管镜检查安全,易耐受.

Analysis of the efficiency and safety of the fibrobronchoscopy in 536 patients

Objective To evaluate the efficiency and safety of the fibrobronchoscope. Methods We investigated 536 patients who accepted fibro branchosoopy during April 2001 to Dct 2002, these patients were divided into two groups according their ages; elder group (group A, with their age 60 or older than 60) and non-elder group (group B, with their age younger than 60). Results Of all the 101 patients in group A, 30 patients (29.7%) where diagnosed to have lung cancer and 2 patients (1.98%) have endobronchial taberculosis. of all the 435 patients in group B, 15 patients (3.45%) were diagnosed to have lung cancer and 17 patients (3.91%) have endobronchial tuberculosis. The difference of the percentage of lung cancer patients between the two groups was significant ( P < 0.01). of all the 30 pa-tionts with lung cancer in group A, 16 patients (53.33%) had squamous cell carcinoma, and 8 patients (26.66%) had adenocarcinoma. Of all the 15 patients in group B, 6 patients (40% ) had undifferentiated carcinoma. The percentage of undifferentiated carcinoma in group B was higher than that in Group A. Of all the bronchial proliferation carcinoma presented in bronchoscopy, squamous cell carcinoma (62. 07% ) and undifferentiated carcinoma (20.70%) were more familiar, while of all the bronchial wall infiltrate carcinoma presented in bronchoscopy, adenocarcinoma (50%) was more familiar. No patient had severe complication and died during the examination. Conclusions Bronchoscopy was most important in the diagnosis of pulmonary diseases, such as lung cancer, endobronchial tuberculosis. The presentation of lung cancer under bronchoscopy was related to its histopathologic types. Bronchoscopy was safe and acceptable.