纤支镜在继发性肺曲菌病中的诊断价值

The diagnostic value of fiberoptic bronchoscopy in the secondary pulmonary aspergillosis

目的探讨纤维支气管镜在继发性肺曲菌病诊断中的临床价值。方法回顾性分析2004年至2008年在我院确诊的11例继发性肺曲菌病患者的临床资料并结合文献复习。结果11例患者中男7例，女4例，年龄19—71岁．年龄超过60岁的老年患者5例。8例有肺部基础疾病，2例为白血病化疗患者，1例为糖尿病冠心病患者，有肺部基础疾病者存在不同程度低氧血症和通气功能障碍。11例患者均经病理学确诊，8例为经纤支镜肺活检获得病理标本，无并发症发生；3例为经手术获得病理标本。痰培养结果仅2例报告霉菌，1例误报毛霉菌。痰涂片结果均为阴性。结论纤支镜在继发性肺曲菌病的诊断中具有重要价值，是获取肺部病理标本的重要手段，对于一般情况差、高龄、有肺部基础疾病的患者，纤支镜检查损伤小、更安全、更适用。

Objective To study the diagnostic value of fiberoptie bronchoscopo in the secondary pulmonary aspergillosis, Methods A retrospective study with literature review was performed on the clinical data of 11 patients with second- ary pulmonary asporgillosis in the 1 st Affiliated Hospital of Guangxi Medical University from 2002 to 2008. Results 11 cases were enrolled,including 7 males and 4 females with age from 19 to 71 years old,and 5 cases were elderly patients of 60 or more years old. 8 cases were combined with primary pulmonary disease,2 with leukemia, 1 with diabetes and coronary heart disease. The patients with basic pulmonary diseases had hypoxemia and ventilation dysfunction. All 11 patients were diagnosed by pathology, among which 8 were diagnosed by fiberoptic brenehoscopo and with no complications, and 3 cases were diagnosed after surgery. Sputum cultures reported mold only in 2 cases and misreported of mucnr in 1 ease. Sputum smear results were all negative. Conclusions Fiberoptic bronehoscope has an important value in the diagnosis of secondary pulmonary aspergillosis, and can serve as an important method to obtain the pathological specimens of lung. It is safer,less injury and more applicable for the eider patients with poor clinical condition and pulmonary diseases.