两种纤维支气管镜活检法在肺周围性疾病中应用的比较

目的探讨和比较成人常规纤维支气管镜盲检和儿童纤维支气管镜引导下成人纤支镜活检在肺周围性疾病诊断中活检成功率、活检诊断准确率及并发症。方法采用奥林巴斯纤维支气管镜活检钳分别通过成人纤维支气管镜远端直接盲检和儿童纤维支气管镜在远端发现病变后通过成人纤支镜活检孔伸出纤维支气管镜活检钳在儿童纤维支气管镜引导直视下活检。70例肺内周围性病变患者随机分为直接通过成人纤维支气管镜远端盲检35例,儿童纤维支气管镜在远端发现病变后通过成人纤维支气管镜活检孔伸出纤维支气管镜活检钳在儿童纤维支气管镜引导直视下活检35例。结果直接通过成人纤维支气管镜远端盲检成功率74%,盲检诊断准确率为62%,2例发生气胸,1例发生需人工干预的出血,3例发生检查后发热。儿童纤维支气管镜引导下成人纤支镜活检成功率94%,盲检诊断准确率为85%,1例发生需人工干预的出血。结论儿童纤维支气管镜引导下成人纤支镜活检在肺周围性疾病诊断中活检诊断准确率高,并发症少,值得推广。

Application Comparison of Two Fibers Bronchoscopic Biopsy in Lung Diseases Around

Objective Explore and compare the success rate,biopsy accuracy rate and complications of biopsy by conventional fiber bronchoscopy for adults and by children fiberoptic bronchoscope in the diagnosis of peripheral lung disease.Methods 70 cases of perpheral lung disease patients were divided randomly into two groups.35 patients received biopsy blindly by conventional adult fiber bronchoscopy,and 35 cases were biopsied by adult fiber bronchoscopy conducted by fiber bronchoscopy for children.Results The success rate was74%,the biopsy accuracy rate was 62% in the group by conventional biopsy method.2 cases of pneumothorax,1 cases of hemorrhage and 3cases of fever occurred after inspection.While 94% of success rate,85% biopsy accuracy rate were achieved by adult fiber bronchoscopy conducted by fiber bronchoscopy for children.And only 1 case of hemorrhage took place.Conclusion Biopsy by adult fiber bronchoscopy conducted by fiber bronchoscopy for children is worthy of recommendation with high success rate and accuracy rate but less complications.