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可弯曲纤维支气管镜检查:适应证、诊断率及并发症

Flexible Fiberoptic Bronchoscopy: Indications, Diagnostic Yield and Complications.

作者信息

Qanash Sultan, Hakami Osamah A, Al-Husayni Faisal, Gari Abdul Ghafoor

机构信息

Internal Medicine, National Guard Hospital, King Abdulaziz Medical City, Jeddah, SAU.

Internal Medicine, Al-Imam Mohammed Ibn Saud Islamic University, Riyadh, SAU.

出版信息

Cureus. 2020 Oct 24;12(10):e11122. doi: 10.7759/cureus.11122.

Abstract

Objective Flexible fiberoptic bronchoscopy (FFB) has become an essential procedure for diagnosing and managing various respiratory conditions. We aimed to assess the main indications, diagnostic yield, and safety of FFB in our institute. Methods A total of 216 patients who underwent FFB between July 2009 and June 2012 at King Abdul-Aziz Medical City, Jeddah, Saudi Arabia, were reviewed retrospectively. Indications of the procedure, the diagnostic yield of variable respiratory diseases, and complications were reported. Result Out of 216 patients, 210 (97.2%) completed FFB. One hundred and ninety-eight (91.7%) bronchoscopies were for diagnostic purposes, and the remaining 12 (5.6%) were for therapeutic aim. The mean age of patients was 50 years ± 20 years and patients. Respiratory infection, malignancy, pulmonary infiltrate in febrile neutropenia (FN), and hemoptysis in order of frequency were the main indications. The overall diagnostic yield was 46%. Mycobacterium tuberculosis (MTB) was the most common indication (26.8%) and was identified in 37.7%, whereas pneumonia was confirmed in 46.3% of the patients. Malignancy was established in 35.3% of suspected cases, while eosinophilic pneumonia was diagnosed in 100%. The diagnostic yield in pulmonary infiltrates of human immunodeficiency viral (HIV) was 85.7%. Alveolar hemorrhage was the most common cause of hemoptysis. Out of therapeutic bronchoscopy, lung collapse was the main indication. There is no mortality and complications occurred in 1.5% of the cases. Conclusion MTB was the most common indication of FFB, followed by malignancy. It has a high diagnostic yield in eosinophilic pneumonia and pulmonary infiltrates in HIV patients. FFB is shown to be a safe modality for diagnostic and therapeutic purposes.

摘要

目的 可弯曲纤维支气管镜检查(FFB)已成为诊断和处理各种呼吸道疾病的重要手段。我们旨在评估我院FFB的主要适应证、诊断阳性率及安全性。方法 回顾性分析2009年7月至2012年6月在沙特阿拉伯吉达阿卜杜勒-阿齐兹国王医疗城接受FFB检查的216例患者。报告了该检查的适应证、各种呼吸道疾病的诊断阳性率及并发症。结果 216例患者中,210例(97.2%)完成了FFB检查。198例(91.7%)支气管镜检查用于诊断目的,其余12例(5.6%)用于治疗目的。患者的平均年龄为50岁±20岁。按出现频率依次为呼吸道感染、恶性肿瘤、发热性中性粒细胞减少症(FN)时的肺部浸润及咯血,是主要适应证。总体诊断阳性率为46%。结核分枝杆菌(MTB)是最常见的适应证(26.8%),确诊率为37.7%,而肺炎确诊率为46.3%。3I.3%的疑似病例确诊为恶性肿瘤,嗜酸性粒细胞性肺炎确诊率为100%。人类免疫缺陷病毒(HIV)肺部浸润的诊断阳性率为85.7%。肺泡出血是咯血最常见的原因。治疗性支气管镜检查中,肺不张是主要适应证。无死亡病例,1.5%的病例出现并发症。结论 MTB是FFB最常见的适应证,其次是恶性肿瘤。FFB对嗜酸性粒细胞性肺炎及HIV患者的肺部浸润诊断阳性率高。FFB是一种安全的诊断和治疗手段。

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