Jurado Gámez B, Sánchez Osuna L, Sánchez Simón-Talero R, García Gil F L, Cosano Povedano A, Muñoz Cabrera L
Servicio de Neumología, Hospital Regional Universitario Reina Sofía, Córdoba.
An Med Interna. 1995 May;12(5):225-8.
We revised our own experience in 208 patients with pleural effusion to whom fiberoptic bronchoscopy was made in part of the diagnostic study. In our population the most frequent cause was neoplastic origen, observing that in 97 patients (46%), 60 of them were due to bronchogenic carcinoma. In relation to the presentation symptoms, just when haemoptysis was present bronchoscopy exhibited bigger diagnostic profitability (17 of 29), p < 0.001. There were 106 patients (51%) who had some or several parenchymatic injuries going with the pleural effusion. In this group, in 55 cases, fiberoptic bronchoscopy was useful to the diagnosis; on the contrary when the only radiologic abnormality was pleural effusion, 102 cases, in 96 of them the procedure was not diagnostic, p < 0.001. A close relationship was noticed between diagnostic profitability of bronchoscopy with the existence of pulmonary neoplasm; about the 61 diagnosed patients using bronchoscopy, 53 of them had bronchogenic carcinoma, p < 0.001. We conclude then in our experience bronchoscopy is useful to the diagnosis of pleural effusion if it goes with haemoptysis or parenchymatic lesions in the radioly. Its diagnostic profitability has close relationship with the existence of bronchogenic carcinoma.
我们回顾了208例胸腔积液患者的自身经验,这些患者在诊断研究的部分过程中接受了纤维支气管镜检查。在我们的研究人群中,最常见的病因是肿瘤性起源,观察发现97例患者(46%)中,60例是由支气管源性癌引起的。关于临床表现,咯血出现时支气管镜检查显示出更高的诊断阳性率(29例中有17例),p<0.001。有106例患者(51%)伴有一些或几种实质性损伤及胸腔积液。在这组患者中,55例纤维支气管镜检查对诊断有帮助;相反,当唯一的影像学异常是胸腔积液时,102例患者中,96例该检查未得出诊断结果,p<0.001。支气管镜检查的诊断阳性率与肺肿瘤的存在之间存在密切关系;在大约61例通过支气管镜检查确诊的患者中,53例患有支气管源性癌,p<0.001。因此,根据我们的经验得出结论,如果胸腔积液伴有咯血或影像学上的实质性病变,支气管镜检查对胸腔积液的诊断是有用的。其诊断阳性率与支气管源性癌的存在密切相关。