电子支气管镜在肺不张诊断及治疗中的临床价值

Clinical value of electronic bronchoscopy in the diagnosis and treatment of atelectasis

目的探讨分析电子支气管镜的应用在肺不张诊断及治疗中的临床价值。方法对2013年3月~2015年3月我院收治的40例肺不张患者的临床资料进行回顾性分析,所有患者均应用电子支气管镜经鼻腔插入,在胸部CT辅助下,对支气管进行全面探查,根据不同情况,给予患者支气管灌洗、刷检、活检的诊断及治疗。观察患者肺不张的部位、发病原因及治疗效果。结果经电子支气管镜检查,原因不明所占百分比(0.00%)明显低于胸部CT原因不明所占百分比(10.00%),差异具有统计学意义(P<0.05)。治疗后,患者临床症状均有不同程度改善,痊愈12例(30.00%),好转26例(65.00%),无效2例(5.00%),总有效率为95.00%。首次治疗无效的肺不张患者,经过二次电子支气管镜治疗后,临床症状均改善。结论电子支气管镜用于肺不张患者的诊断不仅有助于肺不张疾病病因的确定,而且在该疾病治疗过程中具有重要的指导价值,值得进一步推广。

Objective To explore the clinical value of the application of electronic bronchoseopy in the diagnosis and treatment of atelectasis. Methods The clinical data of 40 patients with atelectasis from March 2013 to March 2015 were retrospectively analyzed. All patients were given electronic bronehoscopy via the nasal cavity. With the assistance of the chest CT, the bronchus was comprehensively investigated. According to different circumstances, the diagnosis and treatment by bronchial lavage, brush test and biopsy were given to the patients. The location of atelectasis, the cause of diseases and curative effect were observed in the patients. Results According to the examination of electronic bronchoscopy, the percentage of unknown cause （0.00%） was significantly lower than that of chest CT（10.00%）, and the difference was statistically significant（P〈0.05）. After the treatment, the patient＇s clinical symptoms showed improvement at different degrees. 12 cases （30.00%） were cured, 26 cases（65.00%） were improved, 2 cases（5.00%） were ineffective, with the total effective rate of 95.00%. For the patients with ineffective treatment of atelectasis for the first time, the clinical symptoms were all improved after the second electronic bronchoscopy. Conclusion The diagnosis of electronic bronchoscopy in the patients with atelectasis not only helps to determine the etiology of atelectasis, but also has an important guiding value in the course of treatment of the disease, which is worthy of further promotion.