Keller R, Ruff P, Hausmann M
Pneumologische Abteilung, Klinik Barmelweid, Aarau.
Pneumologie. 1993 Mar;47(3):223-6.
Thoracoscopic lung biopsy is accepted to be an appropriate method in diagnosing interstitial lung diseases when lung tissue examination is needed for accurate diagnosis. In our study of 30 patients with chronic interstitial lung diseases a high sensitivity of 97% was reached similar to the yield reported from open lung biopsy techniques. The manyfold described handicap of long lasting pleural fistula after thoracoscopic biopsies could be prevented in most cases by sealing the biopsy site with a fibrin layer. Thus the mean pleural drainage-time was reduced to 3.7 +/- 1.0 days and only 3 out of the 30 patients required a prolonged drainage up to 11 days. There were only a few minor complications except in one patient who developed an etiologically unclear pulmonary edema shortly after the procedure. However the results obtained by this modified bioptic technique are encouraging and confirm again the efficacy and safety of thoracoscopic lung biopsy in diagnosing interstitial lung diseases.
当需要进行肺组织检查以准确诊断间质性肺疾病时,胸腔镜肺活检被认为是一种合适的诊断方法。在我们对30例慢性间质性肺疾病患者的研究中,达到了97%的高敏感性,与开胸肺活检技术报告的阳性率相似。胸腔镜活检后长期存在的胸膜瘘这一诸多文献描述的不利情况,在大多数病例中可通过用纤维蛋白层封闭活检部位来预防。因此,平均胸膜引流时间缩短至3.7±1.0天,30例患者中只有3例需要延长引流至11天。除1例患者在术后不久出现病因不明的肺水肿外,只有少数轻微并发症。然而,这种改良活检技术所获得的结果令人鼓舞,并再次证实了胸腔镜肺活检在诊断间质性肺疾病方面的有效性和安全性。