Barlési F, Dissard-Barriol E, Gimenez C, Doddoli C, Greillier L, Kleisbauer J-P
Service d'Oncologie Thoracique, Département des Maladies Respiratoires, Hôpital Sainte-Marguerite, Marseille.
Rev Mal Respir. 2003 Jun;20(3 Pt 1):335-40.
Fibreoptic bronchoscopy is currently undertaken by the majority of respiratory physicians, but under varying conditions. Though complications are rare the tolerance of this examination is sometimes poor, particularly when it is performed under local anaesthesia. The undesirable effects may reduce the value of the examination as well as causing discomfort for the patient.
A prospective study of the tolerance of the endoscopic examination was made on 100 consecutive patients by self-administered questionnaire.
There were no major and 7 minor complications (7%). 45% of the patients were anxious but the experience of the operator tended to reassure them (p=0.07). 30% of the patients reported some pain, which tended to be exacerbated by anxiety (44% vs 18%, p=0.008) and the supine position (57% vs 43%, p=0.047). 37% of patients reported nausea, and 50% dyspnoea, without any significant predictive factor. 79% would agree to a repeat examination under the same conditions and 92% said that they had received information appropriate to the examination undergone.
The tolerance of fibreoptic bronchoscopy under local anaesthesia is poor and perhaps overestimated by respiratory physicians. Patient information is essential. A national enquiry could lead to the standardisation of techniques.
目前大多数呼吸内科医生都会进行纤维支气管镜检查，但检查条件各不相同。尽管并发症很少见，但这项检查的耐受性有时较差，尤其是在局部麻醉下进行时。不良影响可能会降低检查的价值，同时给患者带来不适。
通过自行填写问卷，对100例连续患者进行了内镜检查耐受性的前瞻性研究。
无严重并发症，有7例轻微并发症（7%）。45%的患者感到焦虑，但术者的经验往往能让他们安心（p = 0.07）。30%的患者报告有一些疼痛，焦虑（44%对18%，p = 0.008）和仰卧位（57%对43%，p = 0.047）往往会加重疼痛。37%的患者报告有恶心，50%的患者报告有呼吸困难，且无任何显著的预测因素。79%的患者会同意在相同条件下再次检查，92%的患者表示他们已收到与所接受检查相关的信息。
局部麻醉下纤维支气管镜检查的耐受性较差，呼吸内科医生可能对此估计过高。患者信息至关重要。全国性调查可能会促使检查技术标准化。
