试论纤维支气管镜检查在X线胸片阴性肺癌诊断中的伦理问题

分析了24例X线胸片阴性而经纤支镜检查确诊为肺癌患者的临床资料。结果表明:①X线胸片阴性肺癌的病因是病灶被胸腔的其他结构所遮盖或病灶太小(小于1cm);②X线胸片阴性肺癌多以咯血或者痰中带血、喘息、持续发热及刺激性剧烈咳嗽起病,以中心型肺癌和鳞癌居多;③胸部CT可发现部分X线胸片阴性肺癌;④纤支镜检是诊断X线阴性肺癌唯一可靠的方法;⑤纤支镜检过程中的医学伦理。

Value of Fibreoptic Bronchoscopy in the Diagnosis of Lung-cancer Patients With Chest Raoliongraph Negative

To investigate the clinical characteristics of the lung -cancer patients with chest X-rays negative and the value of fibreoptic bronchoscopy in the diagnosis of lung-cancer patients with chest radiograph negative,24lung-cancer patients with chest X-rays negativepathologically proved by Fibreoptic bronchoscopy were retrospectively reviewed.The results shou:(1)the cause of the lung-cancerpatients with chest X-rays chest radiograph negative is that the focus of infection is covered by other structures or it is too small(<1cm);(2)the symptons of lung-cancer patients with chest X-rays negative often start with heamoptysis blood-stained sputum,wheeze,consistent fever or stimulated cough.Most of the cancers are central lung cancer and squamons cell carcimoma;(3) Chest CT may discover part of lung-cancer patients with chest radiograph negative;(4)Fibreoptic bronchoscopy is the solely reliable method in the diagnosis of the lung-cancer patients with chest radiograph negative.(5)the medical ethics of Fibreoptic Bronchoscopy in the diagnosis process.