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目的 :了解上叶肺不张常见病因及纤维支气镜检查对明确诊断的重要性。方法 :用纤维支气管镜对 10 6例上叶肺不张的病人行气管腔内检查 ,结合活检、刷检、抗酸染色等。结果 :10 1例纤支镜检查明确病因学诊断 ,确诊率 10 1/ 10 6 (95 .3% )。右上叶肺不张发生率 (6 3% ) ,总体高于左上叶 (37% )。中老年组上叶肺不张发生率 (76 % )高于青年组 (2 4 % )。中老年上叶肺不张以恶性肿瘤 (6 7% )为主 ,炎症 (15 % )次之 ,结核 (8.6 % )较少见 ;青年人以炎症 (4 8% )为主 ,结核 (16 % )、肿瘤 (12 % )次之。肺癌所致上叶肺不张以中老年男性居多4 7/ 5 4 (87% ) ,以鳞癌居首位 4 2 / 5 4 (77% ) ,。结论 :纤支镜可对上叶肺不张作出病因学诊断 ,确诊率高。中老年上叶肺不张多数由肺癌所致 ,鳞癌居首位 ,青年人上叶肺不张以炎症为主。纤支镜在诊断病因同时尚可起到治疗作用
Objective: To understand the common causes of upper atelectasis and the importance of definitive bronchoscopy. Methods: A total of 106 cases of atelectasis of the upper lobes were treated with endoscopy in bronchoscopy with biopsy, brushing and acid-fast staining. Results: 10 1 cases of bronchoscopy confirmed the etiological diagnosis, the diagnosis rate of 10 1/106 (95.3%). The incidence of atelectasis in the right upper lobe (63%) was generally higher than in the left upper lobe (37%). The incidence of upper atelectasis in middle-aged and elderly patients (76%) was higher than that in youth group (24%). In middle and old age, the majority of patients had atelectasis with malignant tumors (67%), followed by inflammation (15%), and tuberculosis (8.6%) less common. Young people mainly suffered from inflammation (48%) and tuberculosis %), Followed by tumors (12%). The majority of middle-aged and elderly men were mostly pulmonary embolus (47.7% vs 54.7%) and squamous cell carcinoma (42/54) (77%). Conclusion: Fiberoptic bronchoscopy can diagnose the etiology of upper lobe atelectasis, and the diagnosis rate is high. Anemia in middle and old aged leaves mostly caused by lung cancer, squamous cell carcinoma first place, young people on the leaf atelectasis mainly inflammation. Fiberoptic bronchoscopy in the diagnosis of the cause can still play a therapeutic role