间质性肺病肺活检的安全性和诊断价值

Surgical lung biopsy in interstitial lung disease:safety and diagnostic value.

目的 探讨间质性肺病患者行外科肺活检的安全性和诊断价值。方法 回顾性分析 2 0例行外科肺活检的间质性肺病的病例。结果 电视辅助胸腔镜肺活检 13例 ,开胸肺活检 7例 ,术前动脉血氧分压、术后胸腔引流置管天数和胸外科住院天数差异均无显著性 (P >0 0 5 )。 3例术后发生并发症。 19例 (95 % )患者获得特异性的病理诊断 ,进行了相应治疗。结论 外科肺活检具有较高的安全性。作为诊断间质性肺病的方法 ,电视辅助胸腔镜和开胸肺活检均可采用。对于特发性肺纤维化 ,当临床表现、胸部高分辨率CT和支气管镜肺活检不能确诊时 ,应进行外科肺活检。

Objective To evaluate the role of surgical lung biopsy in the diagnosis of interstitial lung disease.Methods The data of 20 patients with interstitial lung disease undergoing surgical lung biopsy were reviewed.Results Thirteen patients received thoracoscopy and 7 thoracotomy.SaO 2,duration of chest tube drainage and hospital stay were not significantly different between the two groups(P>0.05).Three had complications.Definitive pathologic diagnoses were made in 19 (95%) patients.Conclusion Surgical lung biopsy is safe.Both thoracoscopy and thoracotomy are acceptable procedures for diagnostic lung biopsy in diffuse interstitial lung disease.Surgical lung biopsy is most helpful when clinical and radiologic data result in an uncertain diagnosis or when patients are thought not to have IPF.