纤维支气管镜在肺癌诊断中的临床意义

目的：通过分析纤维支气管镜的耐受性、并发症、纤支镜下表现及病理类型,探讨纤支镜检查在肺部肿瘤诊断上的价值。方法：经鼻腔插入纤支镜,直视下或电视透视下对病灶行活检、毛刷,并行检后痰检查。结果：咳嗽、痰血在中央型较多,周围型多无症状。小细胞癌、鳞癌以粘膜上型为主,腺癌以粘膜下型为主,或直视下无异常发现。活检阴性的病灶主要位于上叶及下叶背段。常规纤支镜(TBB)较经支气管镜肺活检(TBLB)的活检、刷检阳性率高(P＜0.05)。结论：纤支镜检查操作方便、病人痛苦小、安全性大、阳性率高,对影像学阴性的肺部肿瘤而言,纤支镜是唯一能获得诊断和正确定位的可靠检查方法。

Clinical Significance of Fiberbronchoscope Diagnosis in Lung Cancer

Objective: To discuss the diagnostic value of fiberbronchoscope detection in lung tumor after analysis of the complications, endurance, manifestations and pathologic types under fiberbronchoscope. Methods: The biopsy, brush and sputum detection was taken with fiberbronchoscope via nasal cavity in straight or video assistant view at the lesion focus. Results: The symptoms of cough and bloody sputum were common in central type and without symptoms in periphery type. The SCLC and squamouscarcinoma was mainly epi-mucosae type. The adenocarcinoma was mainly sub-mucosae type or normal in straight view. The negative biopsy focuses were commonly at superior lobe or dorsal segment of inferior lobe. The positive rate of biopsy and brush detection of TBB was higher than that of TBLB. Conclusions: This method may be convenient to perform, less pain for patient, more safety and higher positive rate. It is reliable detective method to obtain the diagnosis for image mass of lung tumor.