X线胸片正常的咯血患者33例临床分析

Clinical analysis of 33 cases of hemoptysis with normal X-ray chest

目的分析33例X线胸片正常的咯血患者的病因和进一步检查手段的诊断效果。方法以上33例患者在胸片拍摄1周内进行CT扫描、纤维支气管镜检查。结果CT和纤维支气管镜检查后明确诊断29例,总的诊断率为87.9%。4例虽未确诊,但为临床综合分析病因提供了依据。经临床治疗随访的最后明确诊断30例,3例原因不明。结论X线胸片正常咯血患者的病因以炎症或支气管扩张和结核占绝大多数,肺癌比例较少。肺CT和纤维支气管镜检查为明确诊断提供了可靠的依据。

[ Objective] To analyze the etiology of 33 cases of hemoptysis with normal X-ray chest and diagnosis effect of the further examine. [ Methods] 33 cases were examined by CT scan and fiberoptic bronchoscopic in one week after X-ray chest. [ Results] 29 cases were definitely diagnosed by CT scan and fiberoptic bronchoscopic（ 87.9% ）. Though 4 cases were not diagnosed, they provide the evidence for etiology analysis in clinic. Finally 30 cases were diagnosed by clinical therapeutic observation ,3 cases were not confirmed. [ Conclusion] The etiology of hemoptysis patients with normal X-ray chest were mostly inflammation, branch expansion or tuberculosis, and the proportion of lung cancer was less. Lung CT and fiberoptic bronchoscopic provide the credible evidence for accurate diagnosis.