Robbins B E, Steiger Z, Wilson R F, Ratanath V, Karanes C, Bander J, Joseph R, Crane L, Talbert J
Department of Surgery, Wayne State University, Harper Hospital, Allen Park Veterans Administration Medical Center, Detroit, Michigan 48201.
Surg Gynecol Obstet. 1992 Jul;175(1):8-12.
Herein is a review of the results of open biopsies of the lung performed upon immunosuppressed patients between the years 1982 and 1988. The goal was to assess the safety and value of the procedure on a group of patients who are many times in extremis because of multiorgan failure. Obtaining the correct diagnosis and establishing treatment poses a challenge. The study includes 74 patients. Fifty-four had malignant tumors; 20 had various diseases associated with immunosuppression. The biopsy was obtained from the left side in 65 instances. An adequate thoracotomy was done to permit exploration of the thoracic cavity and obtain a representative sample of tissue. The mortality rate related to the operation was 1.4 percent and the complication rate was 11.0 percent. Forty-six percent of the infiltrates were the result of infection. In 42 percent, a change in treatment was made. Thirty-two percent survived and were discharged from the hospital. Patients with adverse drug reaction, with nonspecific pneumonitis and with bacterial infection had a favorable prognosis and benefited most from open biopsy of the lung.
本文回顾了1982年至1988年间对免疫抑制患者进行的开放性肺活检结果。目的是评估该手术对因多器官衰竭而多次处于危急状态的一组患者的安全性和价值。获得正确诊断并确定治疗方案是一项挑战。该研究包括74名患者。54例患有恶性肿瘤；20例患有与免疫抑制相关的各种疾病。65例活检取自左侧。进行了充分的开胸手术，以便探查胸腔并获取具有代表性的组织样本。与手术相关的死亡率为1.4%，并发症发生率为11.0%。46%的浸润是感染所致。42%的患者治疗方案发生了改变。32%的患者存活并出院。药物不良反应、非特异性肺炎和细菌感染患者预后良好，从开放性肺活检中获益最大。
