Altern Ther Health Med. 2024 Jan;30(1):254-259.
Bronchoscopy and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) are two essential methods for obtaining the pathological diagnosis of central lung masses or hilar and mediastinal lymphadenopathy. We can observe that many patients have a fever after examinations, but the pathogenesis is not yet fully clear. We tried to comprehensively assess the occurrence of postoperative fever and bacterial infections in patients undergoing bronchoscopy and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) procedures.
We retrospectively analyzed 512 patients undergoing bronchoscopy or EBUS-TBNA examination. According to examination methods, all patients were classified into three groups: Only perform bronchoscopy examination (BO) group (122 cases)，both perform bronchoscopy and biopsy (BB) group (262 cases), and EBUS-TBNA after bronchoscopy (EBUS) group (128 cases). Peripheral blood leucocyte, neutrophil count, and serum IL-6 test results were obtained before and after the examination. A blood culture was performed when the body temperature was higher than 38.5°C.
Among the three groups, the onset time (5.5h), average duration (6h), and peak temperature (37.7°C) of fever in the BO group were lower than those in the BB and EBUS groups. Still, there was no significant difference in onset time (11.66h, 11.83h), average duration (12.86h, 13.56h), and peak temperature (39.1°C, 39.1°C) between the BB group and EBUS group. There was no significant difference in the peripheral blood leukocyte count, neutrophil count or IL-6 level before the operation (P > .05). Compared with the preoperative, the leukocyte count, neutrophil count and IL-6 level in the three groups were increased after the operation (P < .05). Positive blood cultures were diagnosed as normal oropharyngeal flora.
Postoperative fever after bronchoscopy is a relatively common complication, most of which do not require special treatment. Individuals with concomitant diseases such as diabetes may have postoperative infections after EBUS-TBNA, and they should be emphatically observed. The findings could potentially extend to similar diagnostic procedures or situations in pulmonary medicine. Understanding the risk factors associated with postoperative fever can help healthcare providers manage patient expectations and monitor certain groups more closely.
支气管镜检查和支气管内超声引导经支气管针吸活检（EBUS-TBNA）是获取中央肺部肿块或肺门和纵隔淋巴结病变病理诊断的两种重要方法。我们可以观察到许多患者在检查后会发热，但发病机制尚不完全清楚。我们试图全面评估行支气管镜检查和支气管内超声引导经支气管针吸活检（EBUS-TBNA）的患者术后发热和细菌感染的发生情况。
我们回顾性分析了 512 例行支气管镜或 EBUS-TBNA 检查的患者。根据检查方法，所有患者分为三组：仅行支气管镜检查（BO）组（122 例）、同时行支气管镜和活检（BB）组（262 例）和支气管镜后行 EBUS（EBUS）组（128 例）。检查前后检测外周血白细胞、中性粒细胞计数和血清 IL-6 水平。当体温高于 38.5°C 时进行血培养。
在三组中，BO 组发热的发病时间（5.5h）、平均持续时间（6h）和峰值温度（37.7°C）均低于 BB 组和 EBUS 组，但 BO 组和 EBUS 组的发病时间（11.66h、11.83h）、平均持续时间（12.86h、13.56h）和峰值温度（39.1°C、39.1°C）差异无统计学意义。三组患者手术前后外周血白细胞计数、中性粒细胞计数和 IL-6 水平差异无统计学意义（P＞0.05）。与术前相比，三组患者术后白细胞计数、中性粒细胞计数和 IL-6 水平均升高（P＜0.05）。阳性血培养诊断为正常口腔菌群。
支气管镜检查后发热是一种较为常见的并发症，多数无需特殊治疗。合并糖尿病等疾病的个体行 EBUS-TBNA 后可能发生术后感染，应重点观察。这些发现可能扩展到肺部医学中类似的诊断程序或情况。了解与术后发热相关的危险因素有助于医疗保健提供者管理患者的预期，并更密切地监测某些人群。
