肺不张的病因探讨

目的探讨肺不张的病因,提高肺不张的诊断率。方法对272例经胸部X线片诊断为肺不张的患者进行纤维支气管镜检查,根据镜下所处的部位及形态不同,分别采用活检、刷检,有关细菌学、抗酸杆菌、细胞学、病理学的检查。结果272例肺不张患者病因为肺癌138例(50．7%),病理检查结果鳞癌54例(39．1%),小细胞未分化癌30例(21．7%),腺癌44例(31．9%),大细胞未分化癌10例(7．3%)；炎症居第2位,检出74例(27．2%),经病原学检查：急性细茵学炎症26例(35．1%),慢性细菌学炎症16例(21．6%),肺炎支原体感染20例(27．0%),肺炎衣原体感染8例(10．8%),病茵感染4例(5．4%)；结核居第3位,检出50例(18．4%),其中肺结核14例(28．0%),气管内膜结核10例(20．0%),支气管内膜结核26例(52．0%)。结论肺不张临床表现无特异性,其病因复杂,纤维支气管镜检查是诊断肺不张病因的一项重要技术。

Exploring the Etiology of Atelectasis

Objective To investigate the etiologic causes of atelectasis so that we can improve its diagnostic rate. Methods 272cases with atelectasis confirmed by chest X-ray were examined by Fiberoptic Bronchoscopy.According to the dif- ferent locations and morphology under bronchoscope,they were given biopsy,brush biopsy,and examinations of bacteriology, acid-fast bacilli,cytology,and pathology separately.Results In all these 272cases,138cases(50.7%)were caused by malignant pulmonary tumors,74cases(27.2%)were caused by inflammation,50cases(18.4%)were caused by tuberculosis and 10cases(3.7%)by others.The pathological examination showed,in all the tumors,54cases(39.1%)where squamous carcinoma,30cases(21.7%)where small cell undifferentiated carcinoma,44cases(31.9%)were adenocarcinama and the left 10cases(7.3%)were big cell undifferentiated carcinoma.Inflammation was the second cause of atelectasis,74cases (27.2%)were confirmed.Aetiologieal test reported:there were 26cases(35.1%)with acute bacterial inflammation,16cases (21.6%)cases with chronic bacterial inflammation,20eases(27.0%)with inflammation caused by Mycoplasma Pneumonia, 8cases(10.8%)caused by Chlamydia Pneumonia and 4eases(5.4%)with fungous inflammation.Tuberculosis was the third cause,50cases were confermed,among them,pulmonary tuberculosis was diagnosed in 14eases(28.0%),endotracbeobron- chial tuberculosis was found in 10cases(20.0%)and endobronchial tuberculosis in 26cases(52.0%).Conclusion The clinical manifestations of atelectasis shows no specificity and its causes are complicated.FiberopticBrenchoscopy is a critical tech- nology for diagnosing atelectasis.