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[外科肺活检用于间质性肺疾病:并发症、诊断率及死亡率]

[Surgical lung biopsy for interstital lung diseases: complications, diagnostic yield and mortality].

作者信息

Sakamoto Koji, Yokoyama Toshiki, Aso Hiromichi, Iwaki Mai, Noma Satoshi, Kato Keisuke, Nishiyama Osamu, Kimura Tomoki, Kondoh Yasuhiro, Taniguchi Hiroyuki

机构信息

Department of Respiratory Medicine and Allergy, Tosei General Hospital.

出版信息

Nihon Kokyuki Gakkai Zasshi. 2006 Oct;44(10):675-80.

Abstract

We retrospectively reviewed 110 consecutive patients with interstitial lung diseases (ILDs) who underwent surgical lung biopsy over 13 years from 1989-2002. Surgical procedures, medical records, surgical complications and outcome including post-operative exacerbation of ILDs were assessed in order to clarify the safety and efficacy of surgical lung biopsy. Forty-one patients underwent open lung biopsy (OLB), while 69 patients received videothoracoscopic lung biopsy (VTLB). There was no significant difference in patient characteristics, pulmonary function, arterial oxygen pressure and therapy prior to surgery between the two groups. The mean number of biopsy specimens was 2.5. Left side was selected as the site of biopsy in 70 cases. Duration of surgery was not significantly different between 2 groups. Bleeding during operation was less in the VTLB group than in the OLB group, although the mean bleeding amount was only 16.5mL. The duration of thoracic drainage and length of hospital stay were shorter in the VTLB group. The overall rate of surgical complications was 10.9%, with no difference between the two groups. The overall 30-day post-SLB mortality was 6.4% and majority of these had a very poor prognosis pathologically. The diagnostic yield of all 110 cases was 98.2%. SLB is a relatively safe and efficient diagnostic method in the diagnosis of ILDs.

摘要

我们回顾性分析了1989年至2002年13年间连续接受手术肺活检的110例间质性肺疾病(ILD)患者。评估手术过程、病历、手术并发症及包括ILD术后加重在内的结局,以阐明手术肺活检的安全性和有效性。41例患者接受了开胸肺活检(OLB),69例患者接受了电视胸腔镜肺活检(VTLB)。两组患者的特征、肺功能、动脉血氧分压及术前治疗情况均无显著差异。活检标本的平均数量为2.5个。70例患者选择左侧作为活检部位。两组手术时间无显著差异。VTLB组术中出血少于OLB组,尽管平均出血量仅为16.5mL。VTLB组胸腔引流时间和住院时间较短。手术并发症的总发生率为10.9%,两组之间无差异。SLB术后30天的总死亡率为6.4%,其中大多数患者的病理预后很差。110例患者的诊断阳性率为98.2%。手术肺活检在ILD诊断中是一种相对安全有效的诊断方法。

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