Sharma S K, Dey A B, Pande J N, Verma K
Department of Medicine, All India Institute of Medical Sciences, New Delhi.
Indian J Chest Dis Allied Sci. 1991 Jan-Mar;33(1):15-8.
Over the last 10 years, 53 patients with hemoptysis, but with a normal chest radiograph underwent diagnostic fiberoptic bronchoscopy. Forty-three patients did not show any abnormal findings, the site of bleeding could be localised in five and non-specific mucosal changes were seen in the remaining five patients. Thirty-two patients were followed up clinically for a 3-18 months period. One patient on follow-up developed tubercular pleural effusion. Bronchogenic carcinoma was not detected in any of these patients during the procedure or at follow up. A review of literature revealed a 3 per cent incidence of bronchogenic carcinoma and the risk factors associated with higher incidence were age above 40 years, cigarette smoking and a longer duration of hemoptysis. We conclude that fiberoptic bronchoscopy has little role in this relatively benign condition (hemoptysis) especially when the risk factors are absent.
在过去10年中,53例咯血但胸部X线片正常的患者接受了诊断性纤维支气管镜检查。43例患者未发现任何异常,5例患者出血部位得以定位,其余5例患者可见非特异性黏膜改变。32例患者接受了3至18个月的临床随访。1例随访患者出现结核性胸腔积液。在这些患者的检查过程中或随访期间均未检测到支气管源性癌。文献回顾显示支气管源性癌的发生率为3%,与较高发生率相关的危险因素为年龄超过40岁、吸烟以及咯血持续时间较长。我们得出结论,纤维支气管镜检查在这种相对良性的情况(咯血)中作用不大,尤其是在不存在危险因素时。