电子支气管镜检查联合多种取材方法诊断弥漫性肺间质性疾病的临床研究

The clinical studies of electronic bronchoscopy combined with a variety of materials method in the diagnosis of diffuse interstitial lung disease

目的研究和分析对弥漫性肺间质性疾病（ILD）患者采用电子支气管镜检查联合多种取材方法的临床诊断情况和意义。方法随机选择2011年6月～2014年6月期间,在我院呼吸道科进行就诊的弥漫性肺间质性疾病患者40例。分别对他们进行TBLB（支气管肺活检）检测和电子支气管镜检查联合多种取材方法检测,并就两种临床检测方法的诊断情况和结果进行统计、对比和分析。结果使用TBLB检测出结节病2例,联合检测出结节病2例;使用TBLB检测出继发性肺纤维化4例,联合检测出继发性肺纤维化4例;使用TBLB检测出特发性肺纤维化16例,联合检测出特发性肺纤维化16例;使用TBLB检测出肺结核3例,联合检测出肺结核7例;使用TBLB检测出转移性肺癌1例,联合检测出转移性肺癌3例;使用TBLB检测出原发性肺癌2例,联合检测出原发性肺癌4例,且差异均无统计学意义（P〉0.05）。但联合检测总检出率（90%）明显高于TBLB总检出率（70%）,差异有统计学意义（P〈0.05）。结论对弥漫性肺间质性疾病（ILD）患者应用电子支气管镜检查联合多种取材方法进行临床诊断,其检出符合率高,准确率好,是一种科学、理想、有效的临床诊断方法。

Objective To study and analysis the clinical diagnosis and significance of electronic bronchoscopy combined with a variety of methods in patients with diffuse interstitial lung disease （ILD）. Methods 40 cases of patients with diffuse interstitial lung disease treated in the respiratory department of our hospital from June 2011 to June 2014 were randomly selected. They received the detection of TBLB （bronchial lung biopsy） and electronic bronchoscopy combined with a variety of methods, the diagnostic and results between the two clinical detection methods were statistic, compared and analyzed. Results Two cases of sarcoidosis were detected using TBLB, two cases of sarcoidosis were detected by joint detection;secondary pulmonary fibrosis in four cases were TBLB detected, secondary pulmonary fibrosis four cases were joint detected;idiopathic pulmonary fibrosis with 16 cases were detected by TBLB, idiopathic pulmonary fibrosis with 16 cases were detected by joint detection; three cases of tuberculosis were detected by TBLB, seven cases of tuberculosis were combined detected; one case of metastatic lung cancer was TBLB detected, three cases of metastasis lung cancer were joint detected; two cases of primary lung cancer were TBLB detected, four cases of primary lung cancer were combined detected, all above P〉0.05, the differences had no statistically significant. But total detection rate between the joint detection （90%） was significantly higher than the TBLB detection （70%）, with statistically significant difference （P〈0.05）. Conclusion Clinical diagnosis using combined with a variety of electronic methods in the patients with diffuse interstitial lung disease （ILD）, with high detection rate and better accuracy, is a kind of scientific, ideal, effective clinical diagnosis methods.