[摘要] 目的 探讨纤维支气管镜对肺癌患者的临床诊断价值。 方法 该次研究对象来源于方便选取该院2015年8月―2016年8月收治的肺癌患者56例，均采用纤维支气管镜诊断，分析肺癌病理特征、临床特点，探讨诊断价值。 结果 56例患者中50.0%为鳞癌，明显高于腺癌21.4%、小细胞癌23.2%及大细胞癌1.8%，男性46.2%为鳞癌，女性52.9%为腺癌；刷检阳性率为53.6%，明显低于钳检98.2%，≤40岁肺癌发生率为3.6%，明?@低于41～59岁46.4%与≥60岁发生率48.2%，55.4%病灶分布在叶支气管，30.4%分布在段支气管；浸润性病灶占44.6%，新生物病灶占30.4%，均高于其他病灶表现。 结论 纤维支气管镜诊断肺癌临床意义重大，有推广价值。
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[关键词] 纤维支气管镜；肺癌；临床意义
[中图分类号] R73 [文献标识码] A [文章编号] 1674-0742（2017）08（c）-0034-03
Research on Clinical Significance of Fiberoptic Bronchoscope in Diagnosis of 56 Cases of Patients with Lung Cancer
YAO Mei
Zhaotong Hospital of TCM， Zhaotong， Yunnan Province， 657000 China
[Abstract] Objective To study the clincial value of fiberoptic bronchoscope in diagnosis of patients with lung cancer. Methods Convenient selection 56 cases of paitents with lung cancer admited and treated in our hospital from August 2015 to August 2016 were selected and diagnosed with fiberoptic bronchoscope， and the lung cancer patolgoical features and clinical features were analyzed and the diagnosis value was stuided. Results 56 cases of patients， the incidence rate of squamous cell carcinoma was obvisuly higher than that of adenocarcinoma（50.0% vs 21.4%）， and the incidence rates of small cell carcinoma and large cell carcinoma were 23.2% and 1.8%， and the 46.2% of males were with squamous cell carcinoma and 52.9% of females were adenocarcinoma， and the positive rate of brushing was obviously lower than that of clamp check（53.6% vs 98.2%）， the incidence rate of lung cancer of patients whose age was ≤40 years old， which was obviusly lower than that of patients whose age was obviously lower than 41～59 years old and patients whose age ≥60 years old （3.6% vs 46.4%，48.2%）， 55.4% of patients was distributed in lobar bronchus， 30.4% were distributed in segmental bronchus， infiltrative lesions accounted for 44.6% and neoplasm lesions accounted for 30.4%， which were higher than the manifestaitons of the other lesions. Conclusion The clinical significance of fiberoptic bronchoscope in diagnosis of lung cancer is great， which is worth promotion.
[Key words] Fiberoptic bronchoscope； Lung cancer； Clinical significance
纤维支气管镜为当前临床诊断肺癌的主要方法，其优势在于管镜可弯曲，有较广的观察范围，图像逼真，且局麻下便可操作，故而患者接受度高。为具体探讨纤维支气管镜诊断肺癌的临床意义，现将该院2015年8月―2016年8月收治的肺癌患者56例纳入该研究，现报道如下。
1 资料与方法
1.1 一般资料
该次研究对象来源于方便选取该院收治的肺癌患者56例，其中39例为男性，17例为女性，年龄为38～76岁，平均（56.7±7.4）岁。
1.2 检查方法
开展纤维支气管镜检查，准备好纤维支气管镜与无菌内窥镜活体取样钳，无菌毛刷刷擦钳。签署同意书后行纤维支气管镜检，术前6 h禁水禁食，给予利多卡因（国药准字H20031189）吸入雾化麻醉，再用利多卡因喷雾对咽部及鼻腔予以麻醉，若反应或咽炎强烈喷咽部麻醉效果较差需给予利多卡因漱咽部。术前肌注0.5 mg阿托品（国药准字H33020465）与0.1 mg苯巴比妥（国药准字H12020381），但阿托品不可在青光眼及前列腺增生患者中使用。既往反复发作慢性阻塞性肺疾病史、喘息性支气管炎及支气管哮喘病史者吸入沙丁胺醇吸入剂（批号为H20140029）2～4吸，将支气管扩张。操作前行鼻导管吸氧，监测血压与心率。结合影像学检查结果先在健侧开展纤维支气管镜检查，而后探查患侧，术中活检钳用1～2 mL 1：10 000肾上腺素生理盐水溶液处理病变组织，以收缩血管，将出血量减少。活检病变组织后刷片并灌洗肺泡，开展细胞学与组织学检查，开展免疫组化检查对病理类型予以明确。 1.3 统计方法
应用SPSS 20.0统计学软件处理上述数据，[n（%）]表示计数资料，组间对比为χ2检验，P
发表于 2018-8-15 10:41:12