免疫损害宿主纤维支气管镜术后发热的发生率和相关因素

Incidence and factors related to post-bronchoscopy fever in immunocompromised patients

目的探讨在免疫损害宿主中纤维支气管镜术后发热的发生率和相关因素。方法回顾性分析2006年1月～2008年2月呼吸科住院的免疫损害宿主纤维支气管镜术后发热的临床资料。结果31例患者入选。纤维支气管镜术后发热的发生率为23%,平均术后开始发热时间(3.7±1.2)h,持续时间(9.1±5.2)h,所有患者均于24h内体温恢复正常。发热患者术后白细胞总数及中性粒细胞计数较术前有明显升高。部分患者发热血培养检查未发现任何病原体,术后复查胸片亦未发现新的病灶。单因素分析未能发现任何有统计学意义的危险因子。结论在免疫损害宿主中,纤维支气管镜术后短期发热是常见的并发症,无需特殊处理。

[Objective] To assess the occurrence of fever after fiberoptic bronchoscopy （FOB） and associated risk factors in immunocompromised patients. [Methods] Between January 2006 and February 2008, the clinical data of fever in immunocompromised and hospitalized patients undergoing FOB were retrospectively studied. [Results] Thirty-one adults were included in this study. The incidence of post-bronchoscopy fever was 23%; and the mean onset time of fever was （3.7±1.2） h after FOB, with mean fever duration of （9.1±5.2） h, fever subsided spontaneously within 24 h in all the cases. There were significant increases in total leukocyte and neutrophil counts in the peripheral blood at the time of fever compared to levels prior to FOB. In some patients, blood culture specimens were drawn at the time of fever, but no organisms were isolated, and the simple chest radiographs obtained after FOB were unchanged. No statistically significant risk factors were identified by univariate analysis. [Conclusions] Fever after FOB occurs relatively frequently but transiently in immunocompremised patients with no special treatment needed.