支气管镜检对不明原因胸闷患者的诊断价值研究

Diagnostic value of bronchoscopy on patients with unexplained chest tightness

目的利用电子支气管镜对不明原因胸闷患者进行检查。方法收集我院呼吸内科门诊不明原因胸闷患者78例,电子支气管镜检查,并行支气管刷检、活检、支气管肺泡灌洗液检查。结果支气管镜检查显示:支气管肺癌19例(24.4%),炎性改变17例(21.8%),支气管结核11例(14.1%),痰栓所致肺不张8例(10.3%),支气管异物6例(7.7%),支气管狭窄2例(2.6%),支气管正常改变15例(19.2%)。灌洗液发现可疑肿瘤细胞10例(12.8%),灌洗培养阳性12例(15.4%);黏膜刷检11人次发现抗酸杆菌(14.1%),发现可疑肿瘤细胞6例(7.7%);肿物活检:结核结节7例(9.0%),鳞癌14例(17.9%)腺癌5例(6.4%)。结论电子支气管镜检查及支气管黏膜刷检、肺泡灌洗液、活检,对不明原因胸闷患者病因诊断有重要意义。

Objective To investigate the causes of chest tightness by using electronic bronchoscope in patients with unexplained chest tightness.Methods 78 patients with unexplained chest tightness were given electronic bronchoscopy,bronchial brush inspections,biopsies and bronchoalveolar lavage fluid examinations.Results The results showed 19 cases with bronchogenic carcinoma of lung （24.4％）,17 cases with Inflammatory change （21.8％）,11 cases with endobronchial tuberculosis （14.1％）,8 cases with atelectasis caused by sputum bolt （10.3％）,6 cases with foreign body in bronchus （7.7％）,2 cases with bronchial stenosis （2.6％）,and 15 cases with bronchoscopy normal change （19.2％） respectively.Bronchoalveolar lavage fluid results showed tumor cells in 10 cases （12.8％） and 12 positive culture cases （15.4％）.Bronchial brush inspection showed 11 patients had mycobacterium tuberculosis （14.1％） and 6 cases of suspicious tumor cells （7.7％）.There were 7 cases of tuberculous nodules （9.0％）,14 cases of phosphorus carcinoma （17.9％）,and 5 cases of adenocarcinoma （6.4％） by biopsy.Conclusion It has important significance that bronchoscopy,bronchoalveolar lavage fluid,bronchial brush inspection,mucosal biopsy in the diagnosis of patients with chest tightness.