295例肺上叶阴影病变纤维支气管镜检查与临床分析

OPACITY IN UPPER LOBAR:CLINICAL AND FIBEROPTIC BRONCHOSCOPIC FEATURE IN 295 PATIENTS

目的 :探讨上叶肺部阴影性质与肺段分布的关系。方法 :复习该院 1981～ 1999年 2 95例纤维支气管镜检查的肺上叶部阴影住院病例。对病变的具体部位与患者年龄、性别以及病理诊断之间的关系等进行回顾性分析。结果 :2 95例病人中肺癌 194人 ,其中鳞癌 10 5例 ,肺结核 6 6例 ,肺结核并肺癌 2例。肺部肿瘤所占比重随年龄增大由 30 %到 80 .2 5 %。男性肺癌所占比率为女性 1.46倍。上叶尖、后阴影病变 134例中肺癌 93例(6 9.48% ) ,结核 2 9例 (2 1.6 6 % ) ;94例上叶前段阴影病例中 ,肺部肿瘤 5 3例 (6 1.70 % ) ,结核 2 0例(2 1.30 % )。结论 :肺上叶阴影中肿瘤居多 ,且随年龄增大所占比率上升 ,鳞癌占首位 ,男性肺癌所占比率高于女性 ;病变性质与所处肺段相关性不似文献所述明显 ;结核性病变在纤维支气管镜下具有较特异性表现 ;肺结核可以与肿癌并存。

Objective:To determine if the proportion of bronchial carcinoma in upper lobar in marked different between different segments. Method:295 cases with opacity in upper lobe of lung that were examined using FFB during 1981～1999 in our department were reviewed.Results:The proportion of bronchial carcinoma,tuberculosis,and others was 65.08% (194 cases),22.37%(105 cases) and 11.86% (66 cases)respectively,and there were 2 patients who had carcinoma combined with tuberculosis.The incidence of bronchial carcinoma increased from 30% to 80.25% according to ages.The prevalence rate of lung cancer of male is 0.46 times higher than that of female.Upper lobar apical and posterolateral segments bronchial carcinoma and tuberculosis was found in 69.48% and 21.66% respectively,and the percentage was 61.70% and 21.30% respectively in upper lobar anterolateral segments.Conclusions:The prevalence rate of lung tumor is higher than other disease in patients with opacity in upper lobe of lung.Incidence of bronchial carcinoma was not markedly different between anterolateral segments and posterolateral segments of the upper lobe of lung.Tuberculosis,squamous cell carcinoma and small cell lung cell has more specific feature under endscopy.Lung neoplasm could be co-existance with tuberculosis.