电子支气管镜在肺不张诊治中的应用
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摘要
目的分析电子支气管镜在肺不张病因诊断中的应用价值。方法对我院支气管镜室自2016年11月30日至2017年11月30日诊治的58例肺不张患者的临床资料进行回顾性分析,并进行钳取活检、支气管刷检、选择性支气管灌洗及痰培养等相关检查,分析患者的致病因素并分析电子支气管镜的不良反应发生情况。结果 58例肺不张患者当中,有50例患者经电子支气管镜检查后直接得以明确诊断,支气管镜检查直接诊断率为86.2%,其中炎性病变占60.3%,陈旧性结核者占25.9%,肺癌者占12.1%,异物阻塞者占1.7%;同时,资料显示,选择性支气管灌洗、支气管刷检及钳取活检的诊断率分别为30.8%、50.7%及55.4%,而实施支气管镜检查后配合痰液检查可使诊断率增加9.2%。结论电子支气管镜能够有效提高肺不张病因的诊断率,结合活检、灌洗、刷检及痰液检查等往往可以明确诊断
Objective To analyze the application value of electronic bronchoscope in the diagnosis of atelectasis. Methods Retrospective analysis was performed on the clinical data of 58 patients with atelectasis who were diagnosed and treated in the bronchoscopy department of our hospital from November 30, 2016 to November 30, 2017, and forceps biopsy, bronchial brushing, and selective bronchi were performed. Irrigation, sputum culture, and other related tests were performed to analyze the patient's risk factors and analyze the occurrence of adverse effects of electronic bronchoscopy. Results Of the 58 patients with atelectasis, 50 patients were diagnosed directly by electronic bronchoscopy. The direct diagnostic rate of bronchoscopy was 86.2%, of which inflammatory lesions accounted for 60.3%, and old TB accounted for 25.9%. 12.1% of lung cancer patients accounted for 1.7% of foreign body obstruction; at the same time, data showed that the diagnostic rates of selective bronchial lavage, bronchial brushing, and forceps biopsy were 30.8%, 50.7%, and 55.4%, while the implementation of bronchoscopy with sputum examination can increase the diagnostic rate of 9.2%. Conclusion Electronic bronchoscope can effectively improve the diagnosis rate of atelectasis, combined with biopsy, lavage, brush examination and sputum examination can often confirm the diagnosis
Objective To analyze the application value of electronic bronchoscope in the diagnosis of atelectasis. Methods Retrospective analysis was performed on the clinical data of 58 patients with atelectasis who were diagnosed and treated in the bronchoscopy department of our hospital from November 30, 2016 to November 30, 2017, and forceps biopsy, bronchial brushing, and selective bronchi were performed. Irrigation, sputum culture, and other related tests were performed to analyze the patient's risk factors and analyze the occurrence of adverse effects of electronic bronchoscopy. Results Of the 58 patients with atelectasis, 50 patients were diagnosed directly by electronic bronchoscopy. The direct diagnostic rate of bronchoscopy was 86.2%, of which inflammatory lesions accounted for 60.3%, and old TB accounted for 25.9%. 12.1% of lung cancer patients accounted for 1.7% of foreign body obstruction; at the same time, data showed that the diagnostic rates of selective bronchial lavage, bronchial brushing, and forceps biopsy were 30.8%, 50.7%, and 55.4%, while the implementation of bronchoscopy with sputum examination can increase the diagnostic rate of 9.2%. Conclusion Electronic bronchoscope can effectively improve the diagnosis rate of atelectasis, combined with biopsy, lavage, brush examination and sputum examination can often confirm the diagnosis
引文
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[7]李至兵,徐福兴,李健.俯卧位与压力控制肺复张策略对急性呼吸窘迫综合征患者动脉血气影响的对比研究[J].实用心脑肺血管病杂志,2018,2(8):25-27.
[8]周浩泉,何金根,吕勇,等.纤维支气管镜在婴幼儿肺不张诊治中的应用价值[J].临床儿科杂志,2017,30(9):866.
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[10]熊昊,胡世玲,郭燕妮,等.电子支气管镜在创伤性肺不张患者中的应用[J].西部医学,2012,24(1):48-49.
[2]刘又宁.呼吸内科学[M].北京:中华医学电子音像出版社,2016:5.
[3]吴秩珊.纤维支气管镜在小儿肺不张病因诊断和治疗中的应用价值[J].实用心脑肺血管病杂志,2017,23(7):95-97.
[4]顾颖,卢慧宇,杨雨田,等.纤维支气管镜肺泡灌洗治疗重症肺部感染的临床研究[J].临床肺科杂志,2018,1(10):1254-1255.
[5]王洪武,李冬妹,张楠,等.气管镜治疗187例次因恶性肿瘤引起的阻塞性肺不张的临床分析[J].中国肺癌杂志,2017,14(8):653-659.
[6]管彩虹,楼雅芳,陈旭燕.纤维支气管镜灌洗与常规治疗对重症肺部感染合并肺不张的疗效分析[J].中国内镜杂志,2017,20(6):612-615.
[7]李至兵,徐福兴,李健.俯卧位与压力控制肺复张策略对急性呼吸窘迫综合征患者动脉血气影响的对比研究[J].实用心脑肺血管病杂志,2018,2(8):25-27.
[8]周浩泉,何金根,吕勇,等.纤维支气管镜在婴幼儿肺不张诊治中的应用价值[J].临床儿科杂志,2017,30(9):866.
[9]范丽萍,黄莉,郝创利,等.电子支气管镜在小儿肺不张、肺气肿诊治中的应用[J].临床肺科杂志,2009,14(8):1019-1021.
[10]熊昊,胡世玲,郭燕妮,等.电子支气管镜在创伤性肺不张患者中的应用[J].西部医学,2012,24(1):48-49.