Leijala M, Louhimo I, Lindfors E L
Acta Paediatr Scand. 1982 Sep;71(5):717-20. doi: 10.1111/j.1651-2227.1982.tb09509.x.
During the period 1973-81, open lung biopsy was performed in 33 consecutive children, aged 1 month to 13 years, to exclude or diagnose Pneumocystis carinii pneumonia and to differentiate other interstitial pulmonary lesions. Twenty-one of the patients were undergoing immunosuppressive treatment because of their malignant disease. The clinical diagnosis was correct only in 55% of the patients, but open lung biopsy and histological examination gave the final answer in every patient. Pneumocystis carinii was the causative organism in 67% of the immunosuppressed patients. Nine patients had postoperative complications, 5 of which were mild in nature and resolved spontaneously. Three patients had to be reoperated on for postoperative sequelae. There was one death possibly caused by surgical intervention--tension pneumothorax 10 days after surgery. It is concluded that open lung biopsy is the most reliable method in the diagnosis of diffuse interstitial pneumonitis in children. The need of anaesthesia is no contra-indication and the benefits of the biopsy far outweight the risks of its complications.
在1973年至1981年期间，对33名年龄在1个月至13岁的儿童连续进行了开胸肺活检，以排除或诊断卡氏肺孢子虫肺炎，并鉴别其他间质性肺病变。其中21名患者因患恶性疾病正在接受免疫抑制治疗。临床诊断仅在55%的患者中正确，但开胸肺活检和组织学检查为每位患者给出了最终答案。卡氏肺孢子虫是67%免疫抑制患者的致病原。9名患者出现术后并发症，其中5例性质轻微，可自行缓解。3名患者因术后后遗症需要再次手术。有1例死亡可能是由手术干预导致的——术后10天发生张力性气胸。结论是，开胸肺活检是诊断儿童弥漫性间质性肺炎最可靠的方法。需要麻醉并非禁忌证，活检的益处远大于其并发症的风险。
