Cunningham J H, Zavala D C, Corry R J, Keim L W
Am Rev Respir Dis. 1977 Feb;115(2):213-20. doi: 10.1164/arrd.1977.115.2.213.
Seventy-nine nonthoracotomy lung and bronchial biopsy procedures were performed in 52 immunosuppressed patients: 22 renal transplants, 24 lymphoreticular malignancies, and 6 other disorders. The total diagnostic yield was 74 per cent (23 of 31) of the forcepts transbronchial biopsy procedures, 82 per cent (14 of 17) of the percutaneous trephine lung biopsies, and 28 per cent (9 of 31) of the bronchial brush biopsies. An etiologic diagnosis, including a variety of viral fungal, and parasitic diseases, was obtained in 42 per cent (13 of 31) of the transbronchial biopsy procedures and 65 per cent (11 of 17) of the percutaneous trephine lung biopsies. The etiologic diagnostic yield was increased to 48 per cent when bronchial brushing was combined with forceps transbronchial biopsy. Hemorrhage complicated 26 per cent of the transbronchial biopsy procedures and 17 per cent of the percutaneous trephine biopsies, whereas pneumothorax occurred in 19 per cent and 60 per cent, respectively. Hemorrhagic complications in patients undergoing transbronchial biopsy occurred 3 times as frequently among the uremic patients (5 of 11, 45 per cent) as among the nonazotemic patients (3 of 20, 15 per cent). Patients with thrombocytopenia, when corrected by platelet infusion, presented no increased risk. Of the 52 patients, 19 (36 per cent) died 2 to 60 days after biopsy, but no fatalities were related per se to the biopsy procedure.
对52例免疫抑制患者进行了79次非开胸肺和支气管活检手术：22例肾移植患者，24例淋巴网状系统恶性肿瘤患者，以及6例患有其他疾病的患者。经钳取式经支气管活检手术的总诊断率为74%（31例中的23例），经皮环钻肺活检的诊断率为82%（17例中的14例），支气管刷检活检的诊断率为28%（31例中的9例）。在经支气管活检手术中，42%（31例中的13例）获得了病因诊断，包括各种病毒、真菌和寄生虫疾病；在经皮环钻肺活检中，这一比例为65%（17例中的11例）。当支气管刷检与钳取式经支气管活检联合使用时，病因诊断率提高到了48%。26%的经支气管活检手术和17%的经皮环钻活检出现了出血并发症，而气胸的发生率分别为19%和60%。接受经支气管活检的患者中，出血并发症在尿毒症患者（11例中的5例，45%）中的发生频率是非氮质血症患者（20例中的3例，15%）的3倍。血小板减少的患者在输注血小板纠正后，并未出现风险增加。52例患者中，19例（36%）在活检后2至60天死亡，但没有死亡与活检手术本身直接相关。
