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目的探讨经纤维支气管镜肺活检(TBLB)对弥漫性间质性肺疾病(DILD)的诊断价值。方法 43例弥漫性间质性肺疾病患者在无X线电视透视下行TBLB,对病理结果和临床资料进行分析。结果 43例弥漫性肺疾病中有14例明确了病理学的诊断,确诊率达32.5%。疾病种类主要有肺结核6例,肺泡细胞癌2例,转移性肺癌2例,结节病2例,闭塞型细支气管炎伴机化性肺炎1例,矽肺病1例。临床诊断病例共19例,诊断率达44.1%,结缔组织病肺受累8例,特发性肺纤维化4例,肺结核3例,弥漫性泛细支气管炎1例,癌性淋巴管炎1例,尘肺病2例。未能明确诊断10例(23.2%)。结论纤维支气管镜肺活检对弥漫性肺间质性疾病的诊断是一种可靠、安全、简便、经济的方法 。
Objective To investigate the value of bronchoscopic lung biopsy (TBLB) in the diagnosis of diffuse interstitial lung disease (DILD). Methods Forty-three patients with diffuse interstitial lung disease underwent TBLB without radiography, and the pathological findings and clinical data were analyzed. Results Of the 43 cases of diffuse pulmonary disease, 14 cases had a definite pathological diagnosis with a diagnosis rate of 32.5%. The main types of diseases are pulmonary tuberculosis in 6 cases, alveolar cell carcinoma in 2 cases, metastatic lung cancer in 2 cases, sarcoidosis in 2 cases, occlusive bronchiolitis with opportunistic pneumonia in 1 case, silicosis in 1 case. A total of 19 cases were diagnosed clinically, with a diagnostic rate of 44.1%, 8 cases of pulmonary involvement in connective tissue disease, 4 cases of idiopathic pulmonary fibrosis, 3 cases of pulmonary tuberculosis, 1 case of diffuse bronchiolitis and 1 case of lymphangitic lymphangitis , Pneumoconiosis in 2 cases. Failure to confirm the diagnosis in 10 cases (23.2%). Conclusion Fiberoptic bronchoscopy biopsy is a reliable, safe, simple and economical method for the diagnosis of diffuse interstitial lung disease.