支气管肺泡灌洗和肺活检在白血病患儿肺部浸润治疗中的安全性和益处
Safety and Benefits of Bronchoalveolar Lavage and Lung Biopsy in the Management of Pulmonary Infiltrates in Children With Leukemia.
作者信息
Elbahlawan Lama M, Avent Yvonne, Montoya Libby, Wilder Keith, Pei Deqing, Cheng Cheng, Morrison R R, Jeha Sima
机构信息
*Division of Critical Care Medicine †Division of Patient Care Services ‡Division of Respiratory Care Services Departments of §Biostatistics ∥Oncology, St Jude Children's Research Hospital, Memphis, TN.
出版信息
J Pediatr Hematol Oncol. 2016 Nov;38(8):597-601. doi: 10.1097/MPH.0000000000000644.
Abstract
BACKGROUND
Children with leukemia are at risk of developing life-threatening opportunistic pulmonary infections. The role of bronchoalveolar lavage (BAL) and lung biopsy (BX) in the management of these patients is controversial. In this study, we evaluate the yield and safety of BAL and BX in children with leukemia.
PROCEDURE
We reviewed the records of all children with leukemia who underwent either BAL or BX between 1997 and 2007 at the St Jude Children's Research Hospital.
RESULTS
A total of 64 patients were included, of whom 35 (55%) had BX and 29 (45%) had BAL. Positive results were obtained in 69% of BAL cohort and in 46% of BX cohort. Both procedures resulted in change in antimicrobial coverage (77% in BX, 83% in BAL). Pulmonary hemorrhage occurred in 2 patients, and transient hypoxia was the most frequent complication. All resolved without negatively impacting the clinical course.
CONCLUSIONS
Both BAL and BX are safe and useful in the management of children with leukemia and pulmonary disease.
摘要
背景
白血病患儿有发生危及生命的机会性肺部感染的风险。支气管肺泡灌洗（BAL）和肺活检（BX）在这些患者的治疗中的作用存在争议。在本研究中，我们评估了BAL和BX在白血病患儿中的诊断价值及安全性。
方法
我们回顾了1997年至2007年间在圣裘德儿童研究医院接受BAL或BX检查的所有白血病患儿的记录。
结果
共纳入64例患者，其中35例（55%）接受了BX检查，29例（45%）接受了BAL检查。BAL组69%获得阳性结果，BX组46%获得阳性结果。两种检查方法均导致抗菌药物覆盖范围改变（BX组77%，BAL组83%）。2例患者发生肺出血，短暂性缺氧是最常见的并发症。所有这些情况均得到缓解，且未对临床病程产生负面影响。
结论
BAL和BX在白血病合并肺部疾病患儿的治疗中均安全且有用。
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