2361例不明原因咯血患者支气管镜下特点与临床

Characteristics of 2 361 hemoptysic patients under fiberbronchoscopy

目的了解不明原因咯血患者支气管镜下特点,探讨支气管镜检查对咯血病因诊断的价值。方法结合临床资料对2361例不明原因咯血患者支气管镜镜下表现和病因进行分析。结果2361例不明原因咯血患者镜下表现为管腔内菜花样、乳头状、球形或结节样新生物时93.5%为支气管肺癌,炎症也占有一定比率(4.2%);镜下表现为支气管黏膜肥厚、凹凸不平者支气管肺癌仍然是主要病因,占95.6%,4.2%为支气管结核所致;镜下见黏膜充血水肿、伴或不伴脓性或黏性分泌物是支气管炎性病变的突出表现,支气管炎88.7%、支气管扩张5.1%;而瘢痕狭窄仅见于结核患者。结论不明原因咯血患者支气管镜下表现主要为支气管黏膜充血水肿,其次是管腔内新生物形成,黏膜肥厚、凹凸不平,主要病因分别是支气管肺癌、支气管炎性病变和结核。

[Objective] To investigate the characteristics of 2361 hemoptysic patients under bronchoscopy and to explore the diagnostic value of bronchoscopy in searching the causes of hemoptysis. [Methods] Combined with clinical data, bronchoscopic performance and causes of 2361 hemoptysis patients were analyzed. [Results] Among the 2361 hemoptysic patients, 93.5% of those with bronchoscopic performance of cauliflower-like, nipple-like, spherical or nodular neoplasma were bronchogenic carcinoma, bronchial infection ac...