Department of Emergency, The People's Hospital of Deyang, Sichuan, China.
Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Sichuan, China.
J Coll Physicians Surg Pak. 2021 Dec;31(12):1459-1467. doi: 10.29271/jcpsp.2021.12.1459.
The effects of bronchoscopy and chest CT on early evaluation of patients with hemoptysis are still controversial. PubMed, EMBASE, and the Cochrane Library databases were systematically searched. Odds ratio (OR) was applied to assess the utility of bronchoscopy for hemoptysis etiology and site in comparison with CT in the various clinical processes. A total of 23 studies were included (N=4635). The results showed that bronchoscopy implied a lower overall diagnostic accuracy, especially in identifying the etiology of hemoptysis, compared with CT (OR= 0.34, 95% CI: [0.23, 0.51], OR=0.21, 95% CI: [0.14, 0.31], respectively). When the results of radiograph were normal, the effectiveness of bronchoscopy was significantly weaker than that of CT (OR=0.32, 95% CI: [0.22, 0.45]). In the cases of massive hemoptysis, bronchoscopy and CT had no statistical significance for identifying bleeding (OR=0.27, 95% CI: [0.02, 3.18]). The study suggested that bronchoscopy did not show superior diagnostic accuracy than CT for patients with hemoptysis at the first visit. Key Words: Hemoptysis, Bronchoscopy, CT, Meta-analysis.
支气管镜和胸部 CT 对咯血患者的早期评估效果仍存在争议。我们系统性地检索了 PubMed、EMBASE 和 Cochrane Library 数据库。采用比值比(OR)来评估支气管镜检查在各种临床情况下对咯血病因和部位的诊断效能,与 CT 相比。共纳入 23 项研究(N=4635)。结果表明,支气管镜检查的整体诊断准确性较低,尤其是在识别咯血病因方面,与 CT 相比(OR=0.34,95%CI:[0.23, 0.51],OR=0.21,95%CI:[0.14, 0.31])。当 X 线检查结果正常时,支气管镜检查的效果明显弱于 CT(OR=0.32,95%CI:[0.22, 0.45])。在大咯血患者中,支气管镜检查和 CT 对识别出血无统计学意义(OR=0.27,95%CI:[0.02, 3.18])。研究表明,支气管镜检查在初诊咯血患者中并未显示出比 CT 更高的诊断准确性。关键词:咯血、支气管镜检查、CT、Meta 分析。