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題 名 | Clinical Experience with Surgical Lung Biopsy for Diffuse Pulmonary Lesions=以外科手術肺切片診斷瀰漫性肺疾病的臨床經驗 |
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作 者 | 徐偉樺; 彭明仁; 陳培然; 郭許達; 劉洪彰; 陳瑜珍; | 書刊名 | 胸腔醫學 |
卷 期 | 17:4 2002.12[民91.12] |
頁 次 | 頁324-330 |
分類號 | 416.22 |
關鍵詞 | 瀰漫性肺疾病; 外科手術肺切片; Diffuse lung disease; Surgical lung biopsy; |
語 文 | 英文(English) |
中文摘要 | 前言:瀰漫性肺疾病乃是一群肺部的急慢性發炎與纖維化病變,通常需藉助病史、理學檢查、影像學檢查、痰液分析、血清檢驗、肺功能測驗、乃至組織學來得到正確的診斷。而外科手術肺切片是最終也是準確性最高的診斷工具。 材料與方法:1991年4月到2001年12月期間,我們總共篩選了40位無確切診斷,且已接受開胸肺切片之患者來進行分析。最後有22位患者進入本研究之中,其中男性8位,女性14位,平均年齡50.0歲。所有患者均做過放射線學的檢查,其中也包括了肺功能的檢查。 結果:10位接受術前肺功能測驗的患者當中,40%顯示侷限型肺功能障礙。胸管引流時間,平均為8.9±4.6天;住院日數,平均為22.0±9.3天。主要的術後伴發症為感染症與持續性氣漏。在我們的研究中,病理的診斷率達100%。手術後其中有9個人死亡,其餘繼續在門診追綜當中。 結論:在瀰漫性肺疾病當中,開胸肺切片有著極高的診斷率,與較低的併發症發生率(諸如持續性氣漏、術後感染症等)。在免疫功能正常的患者身上施行此術,可得到極高的診斷率與良好的治療方針;但在面對免疫功能不良的患者時,仍應謹慎為之。 |
英文摘要 | Background: Diffuse pulmonary lesions include a large group of pulmonary disorders associated with inflammatory-fibrotic changes. History, physical examination, imaging studies, sputum analysis, serology, and pulmonary function tests may all contribute to a diagnosis. However, surgical lung biopsy is still required in some patients in order to reach a definitive diagnosis. Materials and Methods: We retrospectively reviewed the charts of 40 patients who had undergone surgical lung biopsy from April 1991 to November 2001. Patients were excluded from the study if their final diagnosis was lung cancer, empyema, or tuberculomas. In the end, we enrolled 22 patients into our study with diffuse pulmonary interstitial infiltrates on radiographic examinations into our study. Ten had had pulmonary function tests which were performed before the surgery. Results: Four of 10 (40%) had a mild to moderate restrictive lung defect and 2 had an obstructive lung defect found on the pre-biopsy pulmonary function tests. Three patients had diminished diffusing capacity. A definitive pathological diagnosis based on the biopsy specimen was made in all 22 patients. The average duration of chest tube placement after open-lung biopsy was 8.9±4.6 days. The average hospitalization was 22.0±9.3 days. The major complication after surgical lung biopsy was infection (13.6%) and persistent air leakage (9.1%). Nine patients died, _8 of them due to their underlying diseases. |
本系統中英文摘要資訊取自各篇刊載內容。