Hedemark L L, Kronenberg R S, Rasp F L, Simmons R L, Peterson P K
Am Rev Respir Dis. 1982 Dec;126(6):981-5. doi: 10.1164/arrd.1982.126.6.981.
Fifty-two episodes of fever and new pulmonary infiltrates were evaluated prospectively in 51 renal allograft recipients. Thirty-nine flexible fiberoptic bronchoscopies were performed in the diagnostic evaluation of these infiltrates. Specific etiologic diagnoses were obtained in 30 (77%) of the patients. This information was clinically useful, as defined by preset criteria, in 21 (54%) of the patients and definitive but not clinically useful in an additional 9 (23%). In the remaining 9, it was neither definitive nor clinically useful. Microbiology brush specimens were useful in establishing etiologic diagnoses in 12 (44%) of the 27 patients in whom it was performed. Transbronchial lung biopsies yielded specific etiologic diagnoses in 9 (53%) of the 17 biopsies obtained. Complications related to the bronchoscopic procedure occurred in 2 patients (5% of total bronchoscopies). No prolonged morbidity was noted. We conclude that fiberoptic bronchoscopy is a safe, useful procedure, and should be considered early in the diagnostic evaluation of pulmonary infections in renal transplant recipients.
对51例肾移植受者的52次发热伴新发肺部浸润情况进行了前瞻性评估。在对这些浸润灶的诊断评估中，共进行了39次可弯曲纤维支气管镜检查。30例（77%）患者获得了明确的病因诊断。根据预设标准，这些信息在21例（54%）患者中具有临床实用性，另有9例（23%）患者诊断明确但无临床实用性。其余9例患者，诊断既不明确也无临床实用性。在进行微生物学刷检的27例患者中，12例（44%）刷检标本有助于明确病因诊断。在获取的17例经支气管肺活检标本中，9例（53%）获得了明确的病因诊断。2例患者（占支气管镜检查总数的5%）出现了与支气管镜检查相关的并发症。未发现长期发病情况。我们得出结论，纤维支气管镜检查是一种安全、有用的检查方法，在肾移植受者肺部感染的诊断评估中应尽早考虑应用。
