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老年人经纤维支气管镜检查后发热与肺炎的前瞻性研究

Prospective study of fever and pneumonia after flexible fiberoptic bronchoscopy in older people.

作者信息

Kanemoto Kouji, Satoh Hiroaki, Ishikawa Hiroichi, Ishikawa Shigemi, Ohtsuka Morio, Sekizawa Kiyohisa

机构信息

Division of Respiratory Medicine, Tsukuba Medical Center Hospital, Tsukuba-city, Ibaraki 305-8575, Japan.

出版信息

J Am Geriatr Soc. 2006 May;54(5):827-30. doi: 10.1111/j.1532-5415.2006.00705.x.

Abstract

OBJECTIVES

To assess the frequency of fever and pneumonia after fiberoptic bronchoscopy (FOB) in older people and to evaluate increased risk for these two adverse events with increasing age.

DESIGN

Prospective study.

SETTING

University hospital system.

PARTICIPANTS

Three hundred fifty-eight patients, with 165 (46.1%) patients aged 70 and older, undergoing bronchoscopy.

MEASUREMENTS

Indications, abnormal bronchoscopic findings, sampling procedures, final diagnosis, and fever and pneumonia after bronchoscopy.

RESULTS

With regard to the indication for bronchoscopy and abnormal bronchoscopic findings, there was no statistical difference between elderly patients (> or =70) and younger patients (<70). Procedures such as forceps biopsy, brushing, and curetting were not performed more often in elderly patients, although final diagnosis of lung cancer was significantly more common in the elderly group (P=.002). The overall incidence of fever after FOB was 6.7%, and that of pneumonia after FOB was 5.6%. The patients aged 70 and older had an incidence of fever after FOB of 3.6% and an incidence of pneumonia of 4.2%, which were not higher than those in patients younger than 70.

CONCLUSION

Increasing age is not associated with increasing fever and pneumonia after FOB, and chronological age should not be considered a limiting factor in the decision of whether to perform FOB when it is clinically indicated.

摘要

目的

评估老年人纤维支气管镜检查(FOB)后发热和肺炎的发生率,并评估随着年龄增长这两种不良事件的风险增加情况。

设计

前瞻性研究。

地点

大学医院系统。

参与者

358例接受支气管镜检查的患者,其中165例(46.1%)年龄在70岁及以上。

测量指标

支气管镜检查的适应证、异常支气管镜检查结果、采样程序、最终诊断以及支气管镜检查后的发热和肺炎情况。

结果

在支气管镜检查的适应证和异常支气管镜检查结果方面,老年患者(≥70岁)和年轻患者(<70岁)之间无统计学差异。钳取活检、刷检和刮除等操作在老年患者中并不更常进行,尽管老年组肺癌的最终诊断明显更常见(P = 0.002)。FOB后发热的总体1发生率为6.7%,FOB后肺炎的发生率为5.6%。70岁及以上患者FOB后发热的发生率为3.6%,肺炎的发生率为4.2%,均不高于70岁以下患者。

结论

年龄增长与FOB后发热和肺炎的增加无关,在临床有指征时,不应将实际年龄视为决定是否进行FOB的限制因素。

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