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目的 :探讨 40岁以上肺不张患者病因特点及纤维支气管镜 (纤支镜 )检查在病因诊断中的价值和应用。方法 :对临床及 X线诊断为肺不张的患者进行纤维支气管镜检查 ,并对其病因、镜下特点、部位分布等进行分析。结果 :肺不张以肺癌最多见 ,共 2 0 8例 ,占 73.2 % ,其中又以鳞癌为最多 ,141例 ,占 6 7.8% ,其次是未分化癌和腺癌 ;炎症5 9例 ,占 2 0 .7% ,居第二位 ;结核 10例 (3.5 % ) ;支气管扩张并血块阻塞 2例 ,异物 1例 ,转移癌 2例 ,外伤后血块及分泌物阻塞 2例 ,各叶肺不张的病因除中叶外 ,均以肺癌为首位 ,中叶不张炎症占 5 6 .2 5 % ,肺癌占 37.5 % ,结核多见于上叶不张。结论 :纤维支气管镜检查是确定肺不张病因最主要的手段 ,并能指导肺不张治疗 ,临床上对原因不明肺不张均应及时进行纤维支气管镜检查。
Objective: To investigate the etiological characteristics of patients with atelectasis over 40 years old and the value and application of bronchoscopy (bronchoscopy) in etiological diagnosis. Methods: Bronchoscopy was performed on patients diagnosed as atelectasis by clinical and X-ray. The etiology, microscopic features and site distribution were analyzed. Results: Atelectasis was the most common cause of lung cancer with a total of 208 cases (73.2%), of which 141 cases were squamous cell carcinoma (7.8%), followed by undifferentiated carcinoma and adenocarcinoma (59.9% Accounting for 20.7%, ranking second; tuberculosis in 10 cases (3.5%); bronchiectasis and clot blocking in 2 cases, foreign body in 1 case, metastatic carcinoma in 2 cases, traumatic occlusion of blood clots and secretions in 2 cases, In addition to the cause of atelectasis in the middle, lung cancer are the first, middle atelectasis inflammation accounted for 52.5%, lung cancer accounted for 37.5%, tuberculosis more common in the upper atelectasis. Conclusion: Fiberoptic bronchoscopy is the most important method to determine the etiology of atelectasis and can guide the treatment of atelectasis. Clinically, fibrobronchoscopy should be performed in time for unknown etiology of atelectasis.