Frazier W D, Pope T L, Findley L J
Department of Internal Medicine, University of Virginia, Charlottesville.
Chest. 1990 Mar;97(3):539-40. doi: 10.1378/chest.97.3.539.
A chest roentgenogram is commonly obtained after a transbronchial biopsy to exclude a pneumothorax. We hypothesized that these routine chest roentgenograms rarely demonstrate a pneumothorax in patients who have neither symptoms nor fluoroscopic findings of lung collapse. To test this hypothesis, we studied 305 consecutive patients undergoing bronchoscopy with fluoroscopically guided TBB. No patient without symptoms and fluoroscopic findings suggesting lung collapse had a pneumothorax demonstrated on the post-biopsy chest roentgenogram. At the University of Virginia, routine chest roentgenograms failed to demonstrate a single unsuspected pneumothorax among all patients undergoing TBB during a period of nearly six years. Given this low incidence of unsuspected pneumothorax, we conclude that routine chest roentgenograms have a low diagnostic yield and may not be necessary in all patients after fluoroscopically guided TBB.
经支气管活检后通常会进行胸部X线检查以排除气胸。我们推测，对于既没有症状也没有肺萎陷荧光镜检查结果的患者，这些常规胸部X线检查很少能显示气胸。为了验证这一假设，我们研究了305例连续接受荧光镜引导下经支气管活检的患者。没有症状且荧光镜检查未发现肺萎陷迹象的患者，活检后的胸部X线检查均未显示气胸。在弗吉尼亚大学，在近六年的时间里，所有接受经支气管活检的患者中，常规胸部X线检查均未发现一例意外气胸。鉴于意外气胸的发生率较低，我们得出结论，常规胸部X线检查的诊断率较低，在荧光镜引导下经支气管活检后的所有患者中可能并非都有必要进行。
