Park Ju-Hee, Kim Soo Jung, Lee Ae-Ra, Lee Jung-Kyu, Kim Junghyun, Lim Hyo-Jeong, Cho Young Jae, Park Jong Sun, Yoon Ho Il, Lee Jae-Ho, Lee Choon-Taek, Lee Sei Won
Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. ; Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Korea.
Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. ; Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Korea. ; Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Yonsei Med J. 2014 May;55(3):739-45. doi: 10.3349/ymj.2014.55.3.739. Epub 2014 Apr 1.
Bronchiectasis is the main cause of hemoptysis. When patients with bronchiectasis develop hemoptysis, clinicians often perform bronchoscopy and bronchial washing to obtain samples for microbiological and cytological examinations. Bronchial washing fluids were analyzed from patients with bronchiectasis who developed hemoptysis, and the clinical impacts of these analyses were examined.
A retrospective observational study of patients who underwent fiberoptic bronchoscopy for hemoptysis in Seoul National University Bundang Hospital, a university affiliated tertiary referral hospital, between January 2006 and December 2010 were reviewed. Among them, patients who had bronchiectasis confirmed by computed tomography and had no definite cause of hemoptysis other than bronchiectasis were reviewed. The demographic characteristics, bronchoscopy findings, microbiological data, pathology results and clinical courses of these patients were retrospectively reviewed.
A total of 130 patients were reviewed. Bacteria, non-tuberculous mycobacteria (NTM), and Mycobacterium tuberculosis were isolated from bronchial washing fluids of 29.5%, 21.3%, and 0.8% patients, respectively. Suspected causal bacteria were isolated only from bronchial washing fluid in 19 patients, but this analysis led to antibiotics change in only one patient. Of the 27 patients in whom NTM were isolated from bronchial washing fluid, none of these patients took anti-NTM medication during the median follow-up period of 505 days. Malignant cells were not identified in none of the patients.
Bronchial washing is a useful method to identify microorganisms when patients with bronchiectasis develop hemoptysis. However, these results only minimally affect clinical decisions.
支气管扩张是咯血的主要原因。当支气管扩张患者出现咯血时，临床医生常进行支气管镜检查及支气管灌洗以获取样本进行微生物学和细胞学检查。对出现咯血的支气管扩张患者的支气管灌洗液进行分析，并研究这些分析的临床影响。
回顾性观察研究2006年1月至2010年12月在首尔国立大学盆唐医院（一所大学附属三级转诊医院）因咯血接受纤维支气管镜检查的患者。其中，回顾性分析经计算机断层扫描确诊为支气管扩张且除支气管扩张外无明确咯血原因的患者。对这些患者的人口统计学特征、支气管镜检查结果、微生物学数据、病理结果及临床病程进行回顾性分析。
共回顾了130例患者。分别从29.5%、21.3%和0.8%的患者支气管灌洗液中分离出细菌、非结核分枝杆菌（NTM）和结核分枝杆菌。仅从支气管灌洗液中分离出可疑致病菌的患者有19例，但仅1例患者因这一分析而更改了抗生素治疗方案。在从支气管灌洗液中分离出NTM的27例患者中，在中位随访期505天内，这些患者均未服用抗NTM药物。所有患者均未发现恶性细胞。
当支气管扩张患者出现咯血时，支气管灌洗是一种识别微生物的有用方法。然而，这些结果对临床决策的影响微乎其微。
