Caughey G, Wong H, Gamsu G, Golden J
Chest. 1985 Nov;88(5):659-62. doi: 10.1378/chest.88.5.659.
We compared conventional bronchoscopic transbronchial biopsy (TBB) and bronchoalveolar lavage (BAL) with non-bronchoscopic bronchoalveolar lavage (NB-BAL) in nine patients with acquired immunodeficiency syndrome (AIDS) and bilateral lung infiltrates. NB-BAL was carried out with a control-tipped reusable catheter. In each patient, bronchoscopic procedures were performed in the right lung, followed immediately by NB-BAL in the left lung. The specimens obtained by NB-BAL confirmed the presence of P carinii pneumonia in seven of eight patients in whom the diagnosis was established by TBB or BAL. Viral cultures of NB-BAL specimens yielded cytomegalovirus (CMV) in four of five subjects with evidence of CMV via bronchoscopic technique, including two instances in which CMV was not detected by BAL. Complications were limited to right-sided pneumothorax attributable to TBB. Accuracy of NB-BAL appears to be comparable to that of conventional bronchoscopic approaches in the diagnosis of AIDS-related pulmonary infection with P carinii or CMV. NB-BAL may be a safer and more economical alternative to TBB and BAL in the diagnosis of pulmonary opportunistic infections.
我们将传统支气管镜下经支气管活检（TBB）和支气管肺泡灌洗（BAL）与非支气管镜下支气管肺泡灌洗（NB - BAL）在9例获得性免疫缺陷综合征（AIDS）合并双侧肺部浸润的患者中进行了比较。NB - BAL采用带控制头的可重复使用导管进行。在每位患者中，先对右肺进行支气管镜检查，随后立即对左肺进行NB - BAL。在通过TBB或BAL确诊的8例患者中，NB - BAL获取的标本证实7例存在卡氏肺孢子虫肺炎。在5例经支气管镜技术证实有巨细胞病毒（CMV）感染迹象的受试者中，NB - BAL标本的病毒培养有4例检出CMV，其中2例BAL未检测到CMV。并发症仅限于TBB导致的右侧气胸。在诊断与AIDS相关的卡氏肺孢子虫或CMV肺部感染方面，NB - BAL的准确性似乎与传统支气管镜检查方法相当。在诊断肺部机会性感染时，NB - BAL可能是TBB和BAL更安全、更经济的替代方法。
