von Eiff M, Steimann R, Roos N, van Husen N, Walger P, Baumgart P, Fegeler W, Junge E, Baumeister H, Wilms B
Medizinische Klinik, Westfälischen Wilhelms-Universität Münster.
Klin Wochenschr. 1990 Apr 2;68(7):372-9. doi: 10.1007/BF01650887.
Bronchoscopy was performed on 101 immunocompromised patients with fever and pulmonary infiltrates. Underlying diseases were mainly hematological malignancies. In 71% of cases, etiology of pneumonia was clarified by nonbioptic bronchoscopic methods (bronchoalveolar lavage, bronchial secretions, protected specimen brush). In 51% of cases, empirical antibiotic treatment was modified following bronchoscopy. In patients with early bronchoscopy a better prognosis regarding healing and survival was observed than in those cases, where bronchoscopy was performed later during pneumonia. Bronchoalveolar lavage was particularly suited for diagnosis of Pneumocystis carinii and pneumonia due to viruses or Legionella. Sensitivity and specificity of bronchoscopy were lower for diagnosis of mycotic pneumonia and of Gram-negative or Gram-positive bacteria.
对101例有发热和肺部浸润的免疫功能低下患者进行了支气管镜检查。基础疾病主要是血液系统恶性肿瘤。在71%的病例中，通过非活检支气管镜检查方法（支气管肺泡灌洗、支气管分泌物、保护性标本刷检）明确了肺炎的病因。在51%的病例中，支气管镜检查后调整了经验性抗生素治疗。与肺炎后期进行支气管镜检查的患者相比，早期进行支气管镜检查的患者在愈合和生存方面预后更好。支气管肺泡灌洗特别适合诊断卡氏肺孢子虫以及病毒或军团菌引起的肺炎。支气管镜检查对霉菌性肺炎以及革兰氏阴性或革兰氏阳性细菌感染的诊断敏感性和特异性较低。
