经支气管镜肺活检对弥漫性肺间质性疾病的诊断价值

The Diagnostic Value of Transbronchial Lung Biopsy Indiffuse Pulmonary Disease

目的:探讨经纤维支气管镜肺活检(TBLB)对弥漫性肺间质性疾病的诊断价值。方法:对51例弥漫性肺间质性疾病患者,在无X线电视透视下行TBLB,对临床资料及病理诊断结果进行分析。结果:51例弥漫性肺疾病中有16例明确了病因学的诊断,确诊率达31.4%,疾病种类主要有肺结核5例(31.3%),普通型间质性肺炎3例(18.8%),肺泡细胞癌2例(12.5%),转移性肺癌2例(12.5%),肺真菌病1例(6.3%)结节病1例(6.3%),肺泡微石症1例(6.3%),闭塞型细支气管炎伴机化性肺炎1例(6.3%)。结合临床诊断病例共28例,诊断率达54.9%,结缔组织病肺受累9例,UIP10例,弥漫性泛细支气管炎2例,癌性淋巴管炎2例,炎性假瘤l例,未能明确诊断7例(13.7%)。结论:纤维支气管镜肺活检对弥漫性肺间质性疾病的诊断是一种可靠、安全、简便、经济的方法,特别是在弥漫性肺疾病诊断中除外结节病、肿瘤和某些特殊类型的感染有重要价值。

Objective This study was to evaluate the efficacy and limitations of transbronchial lung biopsy（TBLB）in the diagnosis of diffuse pulmonary disease.Methods 51 patients of diffuse pulmonary disease were diagnosed with TBLB via fiberoptic bronchoscope without fluoroscopic guidance.The result of clinical data and pathologic diagnosis were underwent retrospectively analyses.Results Confirmed diagnosis by TBLB was obtained in 16 patients,the total positive diagnostic rate was31.4%.The diseases included pulmonary tuberculosis（5/16,31.3%）,lung cancer（4/16,25,0%）,diffuse interstitial pulmonary fibrosis（3/16,18.3%）,pulmonary sarcoidosis （1/16,6.3 % ）,lung fungal infection（1/16,6.3 % ）, bronchiolitis obliterans organizing pneumonia/organizing pneumonia（1/16,6.3%）,pulmonary alveolar microlithiasisetc（1/16,6.3%）. The clinical data diagnosis was 28 patients,the total positive diagnostic rate was 54.9%.Conclusion TBLB in diagnoses of diffuse pulmonary disease is a reliable,safe,handy cheap,may repeatable operational method.