Hill J D, Ratliff J L, Parrott J C, Lamy M, Fallat R J, Koeniger E, Yaeger E M, Whitmer G
J Thorac Cardiovasc Surg. 1976 Jan;71(1):64-71.
Forty-two patients underwent open-lung biopsy during the early phase of acute respiratory insufficiency. Correlation between the gross appearance of the lung at operation and the microscopic findings was good. Although only fair correlation was found between lung and tracheal cultures, the findings of two positive cultures in the lung only was of utmost importance. Biopsying multiple areas from the same operation showed identical pathology in 86 per cent of cases. The mortality rate of open-lung biopsy was zero; the morbidity rate was 4 per cent. The over-all survival rate of acute respiratory insufficiency (ARI) due to trauma was 39 per cent; that of pneumonia, 11 per cent. In 17 (33 percent) patients specific diagnoses and/or specific therapies were employed as a direct result of the biopsy or the thoracotomy. The incidence and prognostic implications of fibrosis and microthromboembolism are presented and discussed. Open-lung biopsy has been extremely safe and valuable in characterizing and managing ARI.
42例患者在急性呼吸功能不全的早期接受了开胸肺活检。手术中肺的大体外观与显微镜检查结果之间的相关性良好。虽然肺培养与气管培养之间仅发现中等程度的相关性，但仅肺培养有两份阳性结果这一发现极为重要。在同一手术中对多个区域进行活检，86%的病例显示病理结果相同。开胸肺活检的死亡率为零；发病率为4%。创伤所致急性呼吸功能不全（ARI）的总体生存率为39%；肺炎所致的为11%。17例（33%）患者因活检或开胸手术直接采用了特异性诊断和/或特异性治疗。文中呈现并讨论了纤维化和微血栓栓塞的发生率及其对预后的影响。开胸肺活检在明确ARI的特征及治疗方面极其安全且有价值。
