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教学医院中可弯曲纤维支气管镜检查的产量与并发症

Yield and complications of flexible fiberoptic bronchoscopy in a teaching hospital.

作者信息

Alzeer Abdulaziz H, Al-Otair Hadil A, Al-Hajjaj Mohammed S

机构信息

Pulmonary Division, Department of Medicine, King Khalid University Hospital, PO Box 18321, Riyadh 11415, Kingdom of Saudi Arabia.

出版信息

Saudi Med J. 2008 Jan;29(1):55-9.

Abstract

OBJECTIVE

To assess the diagnostic yield and safety of flexible fiberoptic bronchoscopy (FFB).

METHODS

A retrospective review of bronchoscopy reports and corresponding patients charts over 3 years from January 2004 - December 2006 in King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia. Indication for procedure, suspected diagnosis, final diagnosis, and complications were reported.

RESULTS

Out of 720 patients, 707 (98.2%) patients had a full follow up. Five hundred and ninety-two (83.7%) underwent FFB for diagnostic purposes and 115 (16.3%) for therapeutic purposes. The mean age was 42 -/+ 18 years. Infection, including mycobacterium tuberculosis, and malignancy were the 2 main indications for FFB (35.9% and 25.9%). The overall diagnostic yield was 58%. Tuberculosis was diagnosed in 67% of suspected cases, whereas bacterial pneumonia was diagnosed in 40.5%. Malignancy was confirmed in 61.2% of suspected cases. Bronchoscopy diagnosed 37 (43%) of 86 patients with interstitial lung disease. The diagnostic yield was 57% for sarcoidosis, 40% for usual interstitial pneumonia and 88% for bronchiolitis obliterans organizing pneumonia. The overall complication rate was 5%; pneumothorax occurred in 0.56% and was associated exclusively with transbronchial biopsy. No mortality was observed.

CONCLUSION

Flexible fiberoptic bronchoscopy is a useful diagnostic tool with a low rate of complications. The diagnostic yield in our institution is similar to that reported in Western series.

摘要

目的

评估可弯曲纤维支气管镜检查(FFB)的诊断率及安全性。

方法

回顾性分析沙特阿拉伯王国利雅得市哈立德国王大学医院2004年1月至2006年12月3年间的支气管镜检查报告及相应患者病历。报告了操作指征、疑似诊断、最终诊断及并发症情况。

结果

720例患者中,707例(98.2%)得到了完整随访。592例(83.7%)因诊断目的接受FFB检查,115例(16.3%)因治疗目的接受检查。平均年龄为42±18岁。感染(包括结核分枝杆菌感染)和恶性肿瘤是FFB的两个主要指征(分别为35.9%和25.9%)。总体诊断率为58%。疑似病例中67%诊断为结核病,40.5%诊断为细菌性肺炎。疑似病例中61.2%确诊为恶性肿瘤。支气管镜检查确诊了86例间质性肺疾病患者中的37例(43%)。结节病的诊断率为57%,寻常型间质性肺炎为40%,机化性肺炎型细支气管炎为88%。总体并发症发生率为5%;气胸发生率为0.56%,且仅与经支气管活检相关。未观察到死亡病例。

结论

可弯曲纤维支气管镜是一种有用的诊断工具,并发症发生率低。我们机构的诊断率与西方系列报道相似。

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