In the past four and one-half years we have used thoracoscopy as the primary technique for pulmonary biopsy in children. During that interval, over 80 thoracoscopic procedures have been performed with no mortality and minimal morbidity. The ages of the patients have ranged between 2 weeks and 20 years. The procedure is carried out in the general operating room under regional and intravenous anesthesia, avoiding the need for endotracheal intubation. Fourty-two of the procedures have been performed in immunosuppressed patients, attempting to determine the presence of Pneumocystis carinii pneumonia. Twenty-four of the procedures have been performed for the diagnosis of intrathoracic tumors while 15 procedures have been performed for the diagnosis of localized pulmonary infiltrates. The diagnostic accuracy in immunosuppressed patients has been 100 persons and in the tumor patients has been 92 percent. The complications of this technique have been minimal. Four patients developed pneumothoraces which responded to manipulation of the chest tube and 3 patients have had sufficient postoperatoire bleeding to require transfusion, while none have required re-exploration. The technique of thoracoscopy has provided a safe and rapid method of pulmonary diagnosis in this aged patient.
在过去四年半的时间里，我们一直将胸腔镜检查作为儿童肺活检的主要技术。在此期间，已进行了80多次胸腔镜手术，无死亡病例，发病率极低。患者年龄在2周至20岁之间。该手术在全身手术室进行，采用区域麻醉和静脉麻醉，无需气管插管。其中42例手术是在免疫抑制患者中进行的，旨在确定是否存在卡氏肺孢子虫肺炎。24例手术用于诊断胸内肿瘤，15例手术用于诊断局限性肺浸润。免疫抑制患者的诊断准确率为100%，肿瘤患者的诊断准确率为92%。该技术的并发症极少。4例患者出现气胸，经胸腔引流管处理后好转；3例患者术后出血较多，需要输血，但均无需再次手术探查。胸腔镜检查技术为该年龄段患者提供了一种安全、快速的肺部诊断方法。
