Mones J M, Saldana M J, Oldham S A
Chest. 1986 Apr;89(4):522-6. doi: 10.1378/chest.89.4.522.
We analyzed the diagnosis of Pneumocystis carinii pneumonia by fiberoptic bronchoscopy in a large series of patients with the acquired immunodeficiency syndrome (AIDS). Transbronchial biopsy fragments, as opposed to endobronchial specimens, were found to have high diagnostic value. Their optimal number for diagnosis was determined by a simple statistical principle. It varied from a minimum of two in cases of severe pneumonia to a maximum of four when roentgenographic manifestations were altogether absent. The diagnostic yield of the transbronchial biopsy alone was 97 percent and that of "touch" preparations of the biopsies 88 percent; when both techniques were combined, the accuracy rose to 98 percent. By comparison, bronchial "washings" and "brushings" had a much lower yield, 59 percent and 57 percent, respectively. Because their diagnostic contribution was negligible, we conclude that the latter two procedures represent an unnecessary expense and waste of technical and professional effort.
我们分析了在大量获得性免疫缺陷综合征（AIDS）患者中通过纤维支气管镜检查诊断卡氏肺孢子虫肺炎的情况。与支气管内标本不同，经支气管活检组织碎片具有很高的诊断价值。其诊断的最佳数量由一个简单的统计学原理确定。在严重肺炎病例中，最少为两片，在完全没有影像学表现时最多为四片。单独经支气管活检的诊断阳性率为97%，活检组织“印片”的诊断阳性率为88%；当两种技术结合时，准确率升至98%。相比之下，支气管“灌洗”和“刷检”的阳性率要低得多，分别为59%和57%。由于它们的诊断贡献可忽略不计，我们得出结论，后两种操作是不必要的费用，也是对技术和专业精力的浪费。
