螺旋CT与电子支气管镜对X线胸片正常咯血患者病因的诊断价值

The Evaluation of Spiral CT and Electronic Bronchoscopy in Pathologic Diagnosis of the Hemoptysic Patients with Normal Roentgenogram

目的探讨胸部螺旋CT和电子支气管镜检查对X线胸片正常咯血患者的诊断价值。方法回顾研究36例X线胸片正常咯血患者的胸部CT和电子支气管镜检查结果,并进行对比分析。结果36例患者中,单纯胸部CT扫描确诊19例(52.8%);电子支气管镜检确诊20例(55.6%);二者联合检查确诊31例(86.1%),3种检查方式确诊率间差异有统计学意义(P<0.05)。结论对于X线胸片正常咯血患者,胸部CT检查是胸片的一个重要补充,电子支气管镜检查对明确病灶性质及咯血原因提供重要依据,二者有互补作用,联合检查能明显提高诊断率。

Objective To investigate and evaluate the etiological diagnostic value of the Spiral Computed Tomography（SCT）scan and electronic bronchoscopy in hemoptysic patients with a normal chest roentgenogram.Methods We have investigated and analyzed the results of chest SCT scan and bronchoscopic exam in 36 hemoptysic patients with normal chest radiography.Results The data showed the accurate diagnosis could be made in 19 cases（52.8%）with SCT scan and 20 cases（55.6%）in bronchoscopy exam respectively.When SCT and bronchoscopy exams are combined,the final diagnostic rate was stirred up to 31 cases（81.1%）.There was significant difference among 3 groups.Conclusion Our study indicates that the chest CT scan is a necessary step for the accurate diagnosis of hemoptysic patient with normal chest x-rays.The electronic bronchoscopy is also necessary for the accurate diagnosis since it plays an important role for identifying and localizing the etiologic origin and hemorrhage site.The combination of SCT and bronchoscopy examinations could lead to better final diagnostic result for these hemoptosic patients in clinic.