Thomas J H, Farek P E, Hermreck A S, Pierce G E
Department of Surgery, University of Kansas Medical Center, Kansas City 66103.
Am J Surg. 1987 Dec;154(6):692-5. doi: 10.1016/0002-9610(87)90246-7.
The records of 46 immunocompromised patients who presented with diffuse pulmonary infiltrates were reviewed to determine the role of open lung biopsy in their management. Fifty-two percent of these patients had underlying hematologic malignancies and 54 percent had received chemotherapy within 3 months prior to biopsy. Forty-six percent were receiving immunosuppressive doses of corticosteroids. A specific diagnosis was obtained in 30 of the 46 patients (65 percent). Fifteen of these patients had pulmonary infections. Nonspecific diagnoses were obtained in 16 of the 46 patients (45 percent). Therapy was altered in a total of 27 patients and 17 of these patients responded to treatment. Overall survival at 1 year was 41 percent. Forty-eight percent of the patients in whom therapy was changed survived 1 year, and 31 percent of the patients in whom therapy was not changed survived 1 year. No deaths were attributable to the operative procedure. The complication rate was acceptable. Open lung biopsy is an important technique in evaluating and determining therapy in immunocompromised patients who present with diffuse pulmonary infiltrates.
对46例出现弥漫性肺部浸润的免疫功能低下患者的记录进行了回顾，以确定开胸肺活检在其治疗中的作用。这些患者中有52%患有潜在的血液系统恶性肿瘤，54%在活检前3个月内接受过化疗。46%的患者正在接受免疫抑制剂量的皮质类固醇治疗。46例患者中有30例（65%）获得了明确诊断。其中15例患者患有肺部感染。46例患者中有16例（45%）获得了非特异性诊断。共有27例患者的治疗方案发生了改变，其中17例患者对治疗有反应。1年时的总体生存率为41%。治疗方案改变的患者中有48%存活了1年，治疗方案未改变的患者中有31%存活了1年。没有死亡病例可归因于手术操作。并发症发生率是可以接受的。开胸肺活检是评估和确定出现弥漫性肺部浸润的免疫功能低下患者治疗方案的一项重要技术。
