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作者介绍一种简单且危险性较小的肺活检方法。检查对象为用其他方法不能确诊的肺部弥漫性病变(68例)和局限性病变(5例)。患者年龄自2～81岁,而以50～70岁者最多。肺活检总的成功率为51％。而肺部弥漫性病变的活检成功率为53.4％。具体方法:先用利多卡因作咽喉局部麻醉,然后藉间接喉镜,将大口径导管插入气管内。或当病人作气管镜检查时,将导管置入。通过导管,将活检钳插入气管内,在透视下,尽量将该钳送至远端。一般可达胸膜下肺组织,尤其容易达到肺下叶基底段。如果病人感觉疼痛,往往表示插入过深,可将活检钳稍退出。在病人平静呼气时,钳取肺组织,作组织学检查。如未取得适当标本,可再次钳取。本组病例共作78次肺活检,成功40次。其中肺弥漫性病变活检73次,成功39次,局限性病变活检5次,仅成功1次。作者认为对局限性病变作活检时,往往易误取病变邻近的正常肺组织。而在弥漫性病变时,钳取病变组织的机会较多。在39次成功的肺活检中,取得病变组织34次,另5次取得正常肺组织。35
The authors describe a simple and less dangerous lung biopsy method. The subjects were lung diffuse lesions (68 cases) and localized lesions (5 cases) that could not be diagnosed by other methods. The patients ranged in age from 2 to 81 years old, and the most were those aged 50 to 70 years. The total success rate of lung biopsy was 51%. The biopsy success rate of lung diffuse lesions was 53.4%. Specific methods: First use lidocaine for local anesthesia of the throat, and then use an indirect laryngoscope to insert a large-caliber catheter into the trachea. Or when the patient performs bronchoscopy, insert the catheter. Through a catheter, the biopsy forceps are inserted into the trachea and the fluoroscope is sent as far as possible to the distal end under fluoroscopy. Generally reach the subpleural lung tissue, especially easy to reach the bottom segment of the lung. If the patient feels pain, it often means that the insertion is too deep and the biopsy forceps can be withdrawn slightly. When the patient calms and exhales, the lung tissue is clamped for histological examination. If no suitable specimen is obtained, it can be clamped again. A total of 78 lung biopsies were performed in this group of patients with 40 successful cases. Among them, 73 cases of diffuse lung lesions were examined, 39 were successful, and 5 cases of focal lesion biopsy were performed successfully. The authors believe that when performing biopsy on localized lesions, it is easy to mistakenly take normal lung tissue adjacent to the lesion. In diffuse lesions, there are more chances to clamp the diseased tissue. In 39 successful lung biopsies, lesions were obtained 34 times and normal lung tissue was obtained 5 times. 35