Bønløkke Søren, Guldbrandt Louise Mahncke, Rasmussen Torben Riis
Lungemedicinsk Afdeling, Aarhus Universitetshospital, Nørrebrogade 44, 8000 Aarhus C, Denmark.
Dan Med J. 2015 Aug;62(8):A5123.
The standard evaluation of haemoptysis in a department of respiratory medicine would currently consist of chest radiography, contrast-enhanced computed tomography (CT) and fibre-optic bronchoscopy (FOB), regardless of the result of the CT. Our aim was to evaluate whether patients presenting with haemoptysis but no positive finding on a contrast-enhanced CT of the chest are at risk for having serious disease, first of all lung cancer, and thus whether FOB is mandatory for such patients.
We searched the literature and retrospectively reviewed all records of patients referred with haemoptysis between 2000 and 2010 at the Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Denmark.
A total of 379 patient records were reviewed for inclusion in the clinical part of the study. Of these, 269 had the information required for the study and had been examined with CT. In all, 16 of the 269 patients were diagnosed with lung cancer. In all of these, a tumour or other findings indicating a possible tumour were seen on the chest CT. No additional cases of lung cancer were discovered during FOB, and no cases had been missed by the CT.
CT should be used as first-line examination in patients with a history of haemoptysis. Furthermore, in patients above 40 years of age with positive findings of any kind on the CT, further examination with FOB is indicated. However, if the chest CT is without pathological findings, it is most unlikely that FOB will reveal anything of significance.
none.
not relevant.
目前，呼吸内科对咯血的标准评估通常包括胸部X光摄影、增强计算机断层扫描（CT）和纤维支气管镜检查（FOB），无论CT结果如何。我们的目的是评估咯血患者胸部增强CT无阳性发现时是否存在患严重疾病（首先是肺癌）的风险，以及此类患者是否必须进行FOB检查。
我们检索了文献，并回顾性分析了2000年至2010年间丹麦奥胡斯大学医院呼吸疾病与过敏科转诊的咯血患者的所有记录。
共查阅了379份患者记录以纳入研究的临床部分。其中，269份有研究所需信息且已接受CT检查。269例患者中，共有16例被诊断为肺癌。所有这些患者的胸部CT上均可见肿瘤或其他提示可能存在肿瘤的表现。FOB检查期间未发现额外的肺癌病例，CT检查也未漏诊任何病例。
CT应作为咯血患者的一线检查。此外，40岁以上CT有任何阳性发现的患者，建议进一步行FOB检查。然而，如果胸部CT无病理发现，FOB极不可能发现有意义的病变。
无。
不相关。
