支气管镜在不明原因慢性咳嗽患者中的诊断应用

目的:分析不明原因慢性咳嗽患者支气管镜检查结果,探讨支气管镜在不明原因慢性咳嗽中病因诊断的价值及安全性。方法:选自2014年6月至2016年11月我院就诊不明原因慢性咳嗽患者50例,行支气管镜检查,并回顾分析其结果。结果:50例患者中,有34例(68%)病因得到诊断,依次包括支气管粘膜慢性炎症9例(18%),气管或支气管内膜结核8例(16%),支气管肺癌7例(14%),真菌感染4例(8%),支气管异物3例(6%),支气管扩张2例(4%),支气管狭窄1例(2%)。16例(32%)未能明确病因。不同年龄组病因构成比差异有统计学意义(H=9.615,P<0.01)。干咳组与湿咳组病因构成比差异有统计学意义(χ2=21.55,P<0.05)。男性与女性慢性咳嗽的病因构成比差异无统计学意义(χ2=6.55,P>0.05)。2例(4%)出现轻度副作用,96%未见任何副反应。结论:支气管镜检查是一种安全有效的检查方法,对不明原因慢性咳嗽的病因诊断具有重要价值,尤其在不同年龄组、不同咳嗽组中。

Objective: To investigate the diagnosis application and safety of bronchoscopy in patients suffering from chronic cough of unknown. Methods: 50 patients with chronic cough of unknown for more than 8 weeks were enrolled for bronchoscopy from June 2014 to November 2016. The data were analyzed retrospectively. Results: Among the 50 cases, 34 cases(68%) were diagnosed, including 9 patients(18%) with chronic bronchitis in the trachea mucosa, 8 patients(16%) with tracheal or bronchial tuberculosis, 7 patients(14%) with lung and bronchus cancer, 4 patients(8%) with fungus infection, 3 patients(6%) with foreign body in bronchus, 2 patients(4%) with bronchiectasis, one patient(2%) with bronchiostenosis, but the negative rate of diagnosis was 32%. The constituent ratio of causes of chronic cough in different age group was different significantly(H=9.615, P<0.01), and was different significantly between cough with sputum group and without sputum group(χ2=21.55, P<0.05). However, there was no difference between male group and female group(χ2=6.55, P>0.05). 2 cases(4%) occurred mild side effects, but 48(96%) were fine. Conclusion: Bronchoscopy is an effective and safe examination to diagnose the cause of chronic cough of unknown, especially in different age group and different sex group.