内科胸腔镜肺活检对弥漫性间质性肺疾病诊断价值及安全性分析

摘要

Objective To investigate the clinical value and safety of thoracoscopic lung biopsy in the diagnosis of diffuse parenchymal lung diseases. Methods 35 patients with diffuse parenchymal lung disease underwent thoraco-scopic lung biopsy were reviewed in order to obtain clinical and pathological data. Results 31 cases were diagnosed by pathology, and the total positive diagnostic rate was 88.6 % (31/35), 10 cases as usual interstitial pneumonial (UIP), 6 cases as Tuberculosis, 4 cases as alveolar cell carcinoma, 3 cases as nonspecific interstitial pneumonia (NSIP), 3 cases as crypto-genieorganizingpneumonia (COP), 2 cases as pulmonary alveolar proteinosis (PAP), 1 case as Wegener's granulomatosis (WG), 1 case as acute interstitial pneumonia (AIP), 1 case as lymphangioleiomyomatosis (LAM). 3 cases (8.6 %) were occurred with postoperative complications, 2 cases as pulmonary infection combined with respiratory failure, 1 case as idiopathic pulmonary fibrosis with acute exacerbation, and 2 cases (5.7 %) were complicated with death. Conclusions Thoracoscopic lung biopsy is a safe and effective method which helps final di-agnosis of diffuse parenchymal lung disease.%目的：探讨内科胸腔镜肺活检对弥漫性间质性肺疾病患者的诊断价值及安全性。方法回顾性分析35例内科胸腔镜肺活检的弥漫性间质性肺疾病患者临床及病理诊断资料。结果31例患者获病理确诊，确诊率88.6%（31/35），其中普通型间质性肺炎（UIP）10例，肺结核6例，肺泡细胞癌4例，非特异性间质性肺炎（NSIP）、隐源性机化性肺炎（COP）各3例，肺泡蛋白沉着症（PAP）2例，韦格纳肉芽肿病（WG）、急性间质性肺炎（AIP）和淋巴管肌瘤病（LAM）各1例。术后并发症3例（8.6%），其中肺部感染合并呼吸衰竭2例，特发性肺间质纤维化急性加重1例，导致死亡2例（5.7%）。结论内科胸腔镜肺活检是诊断弥漫性间质性肺疾病安全有效的方法。