纤维支气管镜检查对胸片正常患者咯血的诊断价值EVALUATION OF FIBEROPTIC BRONCHOSCOPY IN HEMOPTIC PATIBNT WITH NORMAL CHEST ROENTGENOGRAM
巫仁显;张念寅;张国培;
Wu Renxian Dep of Intern Med
摘要(Abstract)：
报告45例胸片正常咯血患者的纤维支气管镜检查结果。发现文气管肺癌10例;支气管内膜结核2例;粘膜炎症改变25例,粘膜血管充盈或充血5例;粘膜正常3例。除支气管肺癌和支气管内膜结核外,其余33例能确定出血部位者只有4例(12%)。10例支气管肺癌的病人均为年龄>40岁的男性,吸烟指数均>400.10例支气管肺癌和2例支气管内膜结核反复咯血日数均>31日,结合文献报告,我们建议:胸片正常咯血患者的纤维支气管检查适应症为①年龄>40岁;②吸烟指数>300,和(或)咯血持续日数>7日。
The results of fiberoptic bronchoscopy in 45 hemoptic patients with normal chest roentgenogram are presented.Bronchoscopic examination showed objective findings of bronchogenic carcinoma in 10 cases;endobronchial tuberculosis in 2 cases;bronchitis in 25 cases;engorgement or congestion of blood vessels in 5 cases,and normal mucous membrane in 3 cases.Bleeding sites were visualized in only 4(12%)of 33 cases other than carcinoma and tuber- culosis.Age older than 40 years,smoking index greater than 400,and hemop- tysis lasting longer than 31 days are presented in all 10 cases of carcinoma. Based on other reports and our study,indications of fiberoptic bronchoscopy in hemoptic patients with normal chest roentgenogram are suggested prelimi- narily as follows:age>40;smoking index>400;and/or hemoptysis lasting>7 days.If all 3 indications are absent,the patients need close obser- vation and sputum careful search for cancer cells or acid-fast bacilli in sputum, if indicated.
关键词(KeyWords)：
咯血;支气管源性癌;肺结核;纤维支气管镜;吸烟
Hemoptysis Tuberculosis,pulmonary Carcinoma,bronchogenic Fiberoptic bronchoscopy Smoking
基金项目(Foundation):
作者(Author):
巫仁显;张念寅;张国培;
Wu Renxian Dep of Intern Med
Email:
DOI: 10.19367/j.cnki.1000-2707.1987.04.010
参考文献(References)：
- 1． Zavala D C.Diagnostic fiberoptic bronchoscopy.Chest 1974;65:616．
- 2． Richardson R H,et al.The use of fiberoptic bronchoscopy and brush biopsy in the diagnosis of suspected
- pulmonary malignancy.Am Rev Resp Dis 1974;109:63．
- 3． 刘瑶华,等.咯血病因分析.中华结核和呼吸系疾病杂志 1986;9:95．
- 4． Weaver L J,et al.Selection of patients with hemoptysis for fiberoptic bronchoscopy.Chest 1979;76:7．
- 5． Adelman M,et al.Cryptogenic hemoptysis.Ann Int Med 1985;102:829．
- 6． Heimer D,et al.Fiberoptic bronchoscopy in patients wltn hemoptysis and nonlocalizing chest roentgenogrom.Arch Int Med 1986;145:1427．
- 7． Gong H,et al.Clinical efficacy of early and delayed fiberoptic bronchoscopy in patients with hemoptysis.Am Rev Resp Dis 1981;124:221．
- 8． Douglass B E,et al.prognosis in idiopathic hemoptysis.JAMA 1952;150:764．
- 9． Barrett R.A study of essential hemoptysis.J Thoracic Cardiov a scul Surg 1960;40:468．
- 10． Snider G I.When not to use the bronchoscope for hemoptysis.Chest 1979;76:1．
- 11． Jackson C V,et al.Role of fiberoptic bronchoscopy in patients with hemoptysis and normal chest
- roentgenogram.Chest 1985;87:142．
文章评论(Comment)：
|
||||||||||||||||||
|
||||||||||||||||||