支气管镜检后发热回顾和前瞻性研究分析

A prospective and retrospective study of clinical characteristics of post-bronchoscopy fever

目的关于纤维支气管镜(纤支镜)检查后发热国内已经有几篇报道,但是该院的情况与报道中不尽一致,该研究旨在探讨该院纤支镜检后发热的发生率和相关因素。方法分别回顾性和前瞻性分析2007年1月～2008年12月和2009年1月～2010年12月在该院内镜中心行支气管镜检的患者,其中回顾性分析入选760例,前瞻性分析入选748例。结果在1508例患者中,出现纤支镜检后发热104人,发生率为6.89%,平均开始发热时间为(4.0±1.5)h,持续时间为(5.2±1.9)h,最高体温为(37.9±0.3)℃,所有患者于24h内体温恢复正常。镜检后发热患者白细胞总数及中性粒细胞计数较镜检前升高,但是24h后基本恢复到镜检前水平。多因素分析未能发现任何有统计学意义的危险因子。结论支气管镜检术后发热虽然有发生,但其发生率并不高;支气管镜检后发热多为一过性发热,无需特殊处理。

[Objective] This study aimed at assessing the incidence and clinical features of post-bronchoscopy fever. [Methods] The study was performed in the outpatient Bronchoscopy Unit of the first hospital of China Medical University. All the patients received routine bronchoscopy without bronchoalveolar lavage （BAL）. From Jan 2007 to Dec 2008, 760 patients who underwent fiberoptic bronchoscopy （FOB） were retrospectively studied. From Jan 2009 to Dec 2010, the clinical characteristics of fever in 748 patients undergoing FOB were prospectively analyzed. [Results] In 1508 patients with routine bronchoscopy, there were 104 cases （6.89%） had post-bronchoscopy fever. The incidence was lower than that descried by several authors. The mean onset time of fever was （4.0±1.5） hours after FOB, with mean fever duration of （5.2±1.9） hours, fever subsided spontaneously within 24 hours. In the patients with fever, the postoperative total number of peripheral blood white blood cells and neutrophil ratio were significantly higher than before FOB examination. [Conclusions] The occurrence of fever is an infrequent event in patients who underwent FOB. Transient fever following bronchoscopy is a common self-limited event which does not need medical intervention.