目的 探討纖維支氣管鏡( 纖支鏡) 及支氣管肺泡灌洗( BAL) 在免疫損害宿主肺部病變中的診斷價(jià)值及并發(fā)癥。方法 收集31 例免疫損害宿主因肺部病變行纖支鏡檢查的臨床資料以及BALF 病原學(xué)檢查結(jié)果。除常規(guī)的微生物檢查外, 采用分子檢測(cè)方法檢測(cè)巨細(xì)胞病毒以及呼吸道病毒。結(jié)果 所有病例均進(jìn)行了BAL, 纖支鏡總的診斷率為65% , 且在感染性疾病中的診斷率較非感染性疾病為高, 分別為86% 和25% 。通過分子檢測(cè)發(fā)現(xiàn)4 例巨細(xì)胞病毒和3 例呼吸道病毒感染病例。結(jié)論 纖支鏡及BAL 對(duì)于明確免疫損害宿主肺部病變的病因是有效和安全的。分子檢測(cè)可幫助提高診斷率。
引用本文： 張鵬宇,張國清,謝國剛,金先橋,周新. 支氣管鏡及支氣管肺泡灌洗在免疫損害宿主肺部病變?cè)\斷中的應(yīng)用. 中國呼吸與危重監(jiān)護(hù)雜志, 2009, 09(3): 259-261. doi: 復(fù)制
| 1. | Shorr AF, Kollef MH. The quick and the dead: the importance of rapid evaluation of infiltrates in the immunocompromised patient.Chest, 2002, 122: 9-12. |
| 2. | Jain P, Sandur S, Meli Y. Role of flexible bronchoscopy in immunocompromised patients with lung infiltrates. Chest, 2004 , 125 :712-722. |
| 3. | Hohenthal U, It l M, Salonen J. Bronchoalveolar lavage in immunocompromised patients with haematological malignancy--value of new microbiological methods. Eur J Haematol, 2005, 74: 203 -211. |
| 4. | Fan J, Henrickson KJ, Savatski LL. Rapid simultaneous diagnosis of infections with respiratory syncytial viruses A and B, influenza viruses A and B, and human parainfluenza virus types 1 , 2, and 3 by multiplex quantitative reverse transcription-polymerase chain reactionenzyme hybridization assay ( Hexaplex) . Clin Infect Dis, 1998, 26 :1397-1402. |
| 5. | Garbino J, Gerbase MW, Wunderli W. Lower respiratory viral illnesses: improved diagnosis by molecular methods and clinical impact. Am J Respir Crit Care Med, 2004, 170: 1197-1203. |
| 6. | 劉靜, 王恒湘, 薛梅. 支氣管鏡及相關(guān)技術(shù)在骨髓移植術(shù)及化療后肺部并發(fā)癥病因診斷中的價(jià)值. 中華內(nèi)科雜志, 2006, 45 : 849 -851. |
| 7. | 鄧小梅, 譚星雨, 王金國, 等. 纖維支氣管鏡術(shù)后發(fā)熱的臨床特點(diǎn). 中華結(jié)核和呼吸雜志, 2005, 28: 830-832. |
| 8. | 劉穎. 纖維支氣管鏡檢查術(shù)后發(fā)熱和感染的分析. 中國醫(yī)師進(jìn)修雜志, 2007, 30: 61-62. |
- 1. Shorr AF, Kollef MH. The quick and the dead: the importance of rapid evaluation of infiltrates in the immunocompromised patient.Chest, 2002, 122: 9-12.
- 2. Jain P, Sandur S, Meli Y. Role of flexible bronchoscopy in immunocompromised patients with lung infiltrates. Chest, 2004 , 125 :712-722.
- 3. Hohenthal U, It l M, Salonen J. Bronchoalveolar lavage in immunocompromised patients with haematological malignancy--value of new microbiological methods. Eur J Haematol, 2005, 74: 203 -211.
- 4. Fan J, Henrickson KJ, Savatski LL. Rapid simultaneous diagnosis of infections with respiratory syncytial viruses A and B, influenza viruses A and B, and human parainfluenza virus types 1 , 2, and 3 by multiplex quantitative reverse transcription-polymerase chain reactionenzyme hybridization assay ( Hexaplex) . Clin Infect Dis, 1998, 26 :1397-1402.
- 5. Garbino J, Gerbase MW, Wunderli W. Lower respiratory viral illnesses: improved diagnosis by molecular methods and clinical impact. Am J Respir Crit Care Med, 2004, 170: 1197-1203.
- 6. 劉靜, 王恒湘, 薛梅. 支氣管鏡及相關(guān)技術(shù)在骨髓移植術(shù)及化療后肺部并發(fā)癥病因診斷中的價(jià)值. 中華內(nèi)科雜志, 2006, 45 : 849 -851.
- 7. 鄧小梅, 譚星雨, 王金國, 等. 纖維支氣管鏡術(shù)后發(fā)熱的臨床特點(diǎn). 中華結(jié)核和呼吸雜志, 2005, 28: 830-832.
- 8. 劉穎. 纖維支氣管鏡檢查術(shù)后發(fā)熱和感染的分析. 中國醫(yī)師進(jìn)修雜志, 2007, 30: 61-62.