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目的探讨电子支气管镜检查联合多种取材方法对弥漫性肺间质性病变(ILD)的临床诊断价值。方法经痰细胞学及细菌学检查均为阴性的弥漫性肺间质性病变129例行电子支气管镜检查,并做镜下钳夹、经支气管肺活检(TBLB)、支气管镜下针吸活检(TBNA)、灌洗(BAL)及刷片(BB)检查,对以上方法的诊断价值进行分析。结果经上述方法确诊特发性肺纤维化64例(49.6%),继发性肺纤维化13例(10.1%),肺癌17例(13.2%),肺结核7例(5.4%)及其它少见的肺部疾病。未能明确诊断者共18例(14.0%);电子支气管镜检查联合多种取材方法较初次TBLB确诊率显著提高,差异有统计学意义(P<0.05)。结论电子支气管镜联合TBLB、TBNA、BAL及BB等检查多种取材方法对ILD的诊断具有重要价值。
Objective To investigate the clinical value of electronic bronchoscopy combined with multiple extraction methods in the diagnosis of diffuse pulmonary interstitial disease (ILD). Methods 129 patients with diffuse pulmonary interstitial lesions who were all negative by sputum cytology and bacteriological examination underwent electronic bronchoscopy and underwent microscopic bronchoscopy, bronchoscopic lung biopsy (TBLB), bronchoscopic needle biopsy TBNA), lavage (BAL) and brush (BB) examination, the diagnostic value of the above methods were analyzed. Results Sixty-four cases (49.6%) of idiopathic pulmonary fibrosis, 13 (10.1%) cases of secondary pulmonary fibrosis, 17 (13.2%) lung cancers, 7 pulmonary tuberculosis (5.4%) and other rare Lung disease. A total of 18 cases (14.0%) failed to confirm the diagnosis. The diagnosis rate of TBLB combined with electronic bronchoscopy combined with multiple samples was significantly higher than that of primary TBLB (P <0.05). Conclusion Electronic bronchoscopy combined with TBLB, TBNA, BAL and BB examination of a variety of methods for the diagnosis of ILD is of great value.