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[胸腔积液患者的支气管镜检查结果]

[Results of bronchoscopy studies in patients with pleural effusion].

作者信息

Marel M, Stastný B, Kozák K, Potocková L, Melínová L, Svandová E

机构信息

II. klinika tuberkulózy a respiracních nemocí fakultní nemocnice I s poliklinikou, Praha.

出版信息

Cas Lek Cesk. 1990 Nov 2;129(44):1389-92.

PMID:2257587
Abstract

The authors investigated in a group of 141 patients included in a study of pleural exudates at the Second Clinic for TB and Respiratory Diseases, Medical Faculty, Charles University Prague, endoscopic findings in correlation with the basic diagnosis and type of exudate. The group comprised 45 women and 96 men, mean age 52 and 54 years resp. 60.3% of the group suffered from neoplastic disease, most frequently bronchogenic carcinoma which was recorded in 56 of the patients. 114 patients were subjected to bronchoscopy, a tumour was detected by this examination in 33%, inflammatory changes in 19%, stenosis of the segments in 9% and merely dilated carinae in 3% of the subjects with pleural exudates who were subjected to bronchoscopy. The authors verified during bronchoscopy by cytological or histological examination 79% bronchogenic carcinomas, 35% other tumours. Bronchoscopy was the decisive examination; due to it the type of exudate was determined in 17 patients, i. c. 12%. In patients with other than neoplastic disease the endoscopic finding supported the basic diagnosis in 30% of the examined subjects, but did not assess the type of exudate in any of the patients. Bronchoscopy revealed pathological changes in 16 patients (11% of the group) where the skiagram of the chest indicated only changes suggesting a pleural exudate. Fifteen of them suffered from neoplastic disease, one from TB of the intrathoracic nodes. The authors conclude that the importance of bronchoscopic examination in patients with pleural exudates is increasing due to the changed spectrum of basic diagnoses and that it should be made in all patients with an obscure pleural exudate.

摘要

作者对布拉格查理大学医学院第二结核病与呼吸疾病诊所一项胸腔积液研究中的141例患者进行了调查,研究内镜检查结果与基本诊断及渗出液类型的相关性。该组包括45名女性和96名男性,平均年龄分别为52岁和54岁。该组60.3%的患者患有肿瘤性疾病,最常见的是支气管源性癌,有56例患者被记录。114例患者接受了支气管镜检查,在接受支气管镜检查的胸腔积液患者中,33%通过该检查发现肿瘤,19%有炎症改变,9%有节段性狭窄,仅3%有气管隆突增宽。作者在支气管镜检查期间通过细胞学或组织学检查证实了79%的支气管源性癌,35%的其他肿瘤。支气管镜检查是决定性检查;由于它确定了17例患者(即12%)的渗出液类型。在非肿瘤性疾病患者中,内镜检查结果在30%的受检者中支持基本诊断,但在任何患者中都未评估渗出液类型。在16例患者(占该组的11%)中,支气管镜检查发现了病理变化,而胸部X线片仅显示提示胸腔积液的改变。其中15例患有肿瘤性疾病,1例患有胸内淋巴结结核。作者得出结论,由于基本诊断范围的变化,支气管镜检查在胸腔积液患者中的重要性日益增加,所有胸腔积液情况不明的患者都应进行支气管镜检查。

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